title: Hostile behaviors predict cardiovascular mortality among men enrolled in the Multiple Risk Factor Intervention Trial.
abstract: BACKGROUND
  Hostility is associated with incident coronary disease in most large population-based studies, but little is known about its association with cardiovascular disease (CVD) mortality in high-risk individuals. The aim of this study was to assess the association of hostility with CVD mortality in the subsequent 16 years in the Multiple Risk Factor Intervention Trial (MRFIT) participants and to explore the influence of hostility in the subset that had a nonfatal CVD event during the trial.
  
  
  RESULTS
  We coded the Structured Interview responses of 259 men who died of CVD during the 16 years of follow-up and 259 matching living control subjects. Signs of hostility were assessed by use of the Interpersonal Hostility Assessment Technique. Matching was based on center, intervention group, age, race, and interviewer; covariates included study entry diastolic blood pressure, cholesterol, smoking status, and nonfatal CVD event during the trial. High-hostile men were more likely to die of CVD than were low-hostile men. Adjusted odds ratio (OR) and 95% confidence intervals (CIs) were 1.61, 1.09 to 2.39. After the trial, high-hostile men who also had a nonfatal event during the trial were particularly likely to die of CVD, OR, 5.06, 1.42 to 8.22, compared with low-hostile men without a nonfatal event during the trial.
  
  
  CONCLUSIONS
  Hostility may be a risk factor for CVD mortality among high-risk men. Interventions aimed at anger management and stress reduction along with risk factor modification may be useful for hostile patients.
authors.affiliation: University of Pittsburgh, 3811 O'Hara St, Pittsburgh, Pa 15213, USA. matthewska@upmc.edu
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.forename: Brooks B
authors.initials: BB
authors.lastname: Gump
authors.forename: Kelly F
authors.initials: KF
authors.lastname: Harris
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Haney
authors.forename: John C
authors.initials: JC
authors.lastname: Barefoot
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality* / Q000523:psychology*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000517:prevention & control; D005500:Follow-Up Studies; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors