Hostility and physiological risk in the National Heart, Lung, and Blood Institute Family Heart Study

Arch Intern Med. 2004 Dec 13-27;164(22):2442-8. doi: 10.1001/archinte.164.22.2442.


Background: The present analyses investigated possible pathways for earlier reported associations in the National Heart, Lung, and Blood Institute Family Heart Study between hostility and coronary and carotid end points.

Methods: The cross-sectional design recruited 535 women and 491 men with average familial risk for coronary heart disease and 1950 women and 1667 men with high familial coronary risk from 3 prospective ongoing studies at 4 sites. Recruitment of high-risk participants was based on family risk score. Average-risk participants came from a randomly selected group. Outcome measures were plasminogen activator inhibitor type 1 (PAI-1), homocysteine, fibrinogen, fasting glucose, blood pressure, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, and "lipid metabolic disorder" (LMD) (defined as systolic blood pressure >/=140 mm Hg or diastolic blood pressure >/=90 mm Hg); fasting glucose >/=126 mg/dL (>/=7.0 mmol/L) or the use of diabetes medications; body mass index (calculated as weight in kilograms divided by the square of height in meters) >/=30; triglycerides >/=250 mg/dL (>/=2.8 mmol/L), high-density lipoprotein cholesterol <40 mg/dL (<1.0 mmol/L) in men and <50 mg/dL (<1.3 mmol/L) in women; and low-density lipoprotein cholesterol level >/=130 mg/dL (>/=3.4 mmol/L).

Results: After adjustment for age and risk-related behaviors, hostility was significantly associated with glucose level and LMD in high-risk women, with LMD in average-risk women, with PAI-1 and LMD in high-risk men, and with fibrinogen level in average-risk men.

Conclusions: Associations between hostility and physiological risk were only partially accounted for by health behaviors, suggesting that further investigation of mechanistic pathways is warranted.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Blood Glucose / analysis
  • Blood Pressure
  • Cardiovascular Diseases / etiology*
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Female
  • Fibrinogen / analysis
  • Homocysteine / blood
  • Hostility*
  • Humans
  • Male
  • Plasminogen Activator Inhibitor 1 / blood
  • Prospective Studies
  • Risk Factors
  • Triglycerides / blood


  • Blood Glucose
  • Cholesterol, HDL
  • Plasminogen Activator Inhibitor 1
  • Triglycerides
  • Homocysteine
  • Fibrinogen