Anger-related personality traits and carotid artery atherosclerosis in untreated hypertensive men.
OBJECTIVE
To determine whether anger-related personality traits are associated with carotid artery atherosclerosis in untreated hypertensive patients.


METHODS
Study participants were 237 men with elevated blood pressure (systolic 140-180 mm Hg and/or diastolic 90-110 mm Hg) but untreated for hypertension. Average age was 56 years; 80% of subjects were white. Eighty-six percent had no history of antihypertensive treatment, and the remainder reported median lifetime treatment exposure of 4 months. Subjects were administered the Spielberger State-Trait Anger Expression Inventory, which measures tendencies to experience anger (Trait Anger) and modes of anger expression (Anger-In, Anger-Out, Anger-Control). Mean and maximum intima-medial thickness (IMT) and plaque occurrence in the extracranial carotid arteries were measured by B-mode ultrasonography.


RESULTS
Trait Anger was marginally (p =.065) related to mean and significantly (p <.05) related to maximum IMT, independent of standard risk factors (age, race, body mass index, education, smoking, fasting glucose, total:high-density lipoprotein cholesterol ratio). A component of Trait Anger, Angry Temperament, similarly predicted mean (p =.062) and maximum IMT (p <.05) and plaque occurrence (p <.05). Anger-Out predicted both mean and maximum IMT (p values <.01).


CONCLUSIONS
An antagonistic disposition (Trait Anger), particularly a tendency to experience anger on minimal provocation (Angry Temperament) and a propensity to express anger outwardly (Anger-Out), are associated with heightened carotid atherosclerosis. These findings suggest that recently reported prospective associations between these anger dimensions and incident cerebrovascular disease may be mediated, in part, by increased atherosclerotic disease.
Bleil
Maria E
ME
Behavioral Physiology Laboratory, Department of Psychology, University of Pittsburgh, 4015 O'Hara St., Pittsburgh, PA 15260, USA. bleil@pitt.edu
McCaffery
Jeanne M
JM
Muldoon
Matthew F
MF
Sutton-Tyrrell
Kim
K
Manuck
Stephen B
SB
D000367:Age Factors; D000786:Anger; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015897:Comorbidity; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010551:Personality; D010555:Personality Inventory / Q000706:statistics & numerical data; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology; D013694:Temperament; D018616:Ultrasonography, Doppler, Duplex