This is the first of an ongoing series about little known factors that play a significant role in the development of coronary artery (heart) disease.

Part 1:

Heart disease is the leading cause of death in industrialized nations. It’s physical “causes” have been studied for many years. A significant number of research studies have clearly demonstrated that beyond the known risk factors–smoking, obesity, high cholesterol levels, hypertension, a sedentary life style, and diabetes–subtler emotional factors such as hostility, isolation, and depression, are also responsible for coronary artery disease.

For many years, the “Type A” personality–always in a hurry, quick to anger, and highly competitive–was touted as a principal contributor to heart attacks. But as research became more common in this area, studies refined the behavioral profile of potential heart attack victims, and the Type A personality did not consistently predict the development of heart disease.

Redford Williams of Duke University Medical Center found, for example, that a cynical mistrust of others, the overt expression of this cynicism, and hostility expressed in aggressive behavior accounted for higher mortality related to heart disease. “Hostility flares like a beacon, a risk factor that needs to be tempered,” Williams wrote in his book, Anger Kills.

But while it may be critical to one’s health to recognize unrelenting anger as a toxic, health-damaging personality trait, it is equally important to know that it can be modified with behavioral therapy and a commitment to change. An international study conducted in Canada, the United States, and Israel, “The Short-Term Effects of Hostility-Reduction Intervention on Male Coronary Heart Disease Patients,” which was published in Health Psychology (July 1999), evaluated the effectiveness of an intervention aimed at reducing hostility in patients with coronary artery disease. The project found that heart patients who released at least some of their hostility were able to significantly reduce their blood pressure.

Still the effects of hostility are many. One study conducted by the Massachusetts Department of Public Health in 1972, found that, in individuals age 50 and younger, unhappiness was the greatest predictor of heart disease and heart attacks. In his book, Williams connects hostility to unhappiness. He cites a study, “Cynical Hostility at Home and Work: Psychosocial Vulnerability Across Domains,” conducted by Timothy Smith, a University of Utah researcher and his colleagues and published in the Journal of Research in Personality (December 1988), which found that college students, who score high on a hostility questionnaire, a part of the Minnesota Multiphasic Personality Inventory (MMPI), a standard psychological test, reported more hassles and negative life events, along with less social support. Williams also points out that hostile people had more marital problems and conflicts in their families. Thus, hostility led to another contributor to heart disease: isolation, which we’ll discuss in our next issue.

Beyond Cholesterol by Elaine R. Ferguson, MD Alternative Medicine Digest Magazine