Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: a prospective study in the normative aging study.
BACKGROUND
Anger, anxiety, and depression have each been identified as risk factors for coronary heart disease (CHD). Whether the apparent risk is a function of unique aspects of each emotion or due to a shared underlying dimension of negative affectivity is unclear.


OBJECTIVE
The goal of this study was to assess shared and unique contributions of anger, anxiety, and depression to incident CHD.


METHODS
Data are from the Veterans Administration Normative Aging Study, an ongoing cohort of older men. Measures of anger, anxiety, and depression were obtained from 1,306 men completing the revised Minnesota Multiphasic Personality Inventory in 1986. From these measures we derived three near-orthogonal scales termed iso(lated)-anger, iso-anxiety, and iso-depression and a fourth scale measuring general distress.


RESULTS
During an average of 10.9 years of follow-up, 161 cases of incident CHD occurred. When considered individually, iso-anxiety, iso-anger, and shared general distress were each associated with CHD risk. When all emotions were considered simultaneously, only iso-anxiety and shared general distress were associated with incident CHD.


CONCLUSIONS
Considering shared versus unique aspects of negative emotions may clarify the nature of their apparent toxicity in relation to CHD risk. General distress shared across negative emotions is an important component in the emotion-CHD relation. Aspects of anxiety may also independently increase CHD risk.
Harvard School of Public Health.
Laura D
LD
Kubzansky
Stephen R
SR
Cole
Ichiro
I
Kawachi
Pantel
P
Vokonas
David
D
Sparrow
D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000786:Anger; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology*; D003327:Coronary Disease / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires