title: Suppressed anger is associated with increased carotid arterial stiffness in older adults.
abstract: BACKGROUND
  Anger and hostility have been implicated in the pathogenesis of heart disease, but the extent to which the large conduit arteries play an intermediate role in this relationship remains to be clarified. The present study investigated associations of anger frequency and expression style with carotid artery intima-media thickness (IMT) and stiffness in healthy adults older than 50 years.
  
  
  METHODS
  Two hundred participants (95 men) in the Baltimore Longitudinal Study of Aging completed the Spielberger Anger Expression Inventory, which assesses anger frequency (trait anger), anger expression (anger-out), and anger suppression (anger-in). The carotid artery IMT was assessed by ultrasonography. Carotid stiffness was determined from the log of systolic over diastolic blood pressure (BP) as a function of carotid distensibility.
  
  
  RESULTS
  In univariate correlational analysis, a significant positive association of anger-in with stiffness was observed (P < .01), together with a less significant association of anger-in with carotid artery IMT (P < .05). Neither anger-out nor trait anger was significantly associated with carotid artery IMT or stiffness. Moreover, none of the anger measures was significantly associated with resting BP in this normotensive sample. As expected, carotid artery IMT, stiffness, and systolic BP were all positively associated. In multivariate analysis, anger-in remained a determinant of stiffness independent of BP, and a marginally significant determinant of carotid artery IMT.
  
  
  CONCLUSIONS
  This is the first known finding that high anger-in is a significant independent determinant of carotid artery stiffness. These results suggest that high anger-in can potentiate the effects of age on stiffening of the central arteries.
authors.affiliation: Laboratory of Cardiovascular Science, National Institute on Aging, Baltimore, Maryland 21224, USA. AndersoD@GRC.NIA.NIH.GOV
authors.forename: David E
authors.initials: DE
authors.lastname: Anderson
authors.forename: E Jeffrey
authors.initials: EJ
authors.lastname: Metter
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Hougaku
authors.forename: Samer S
authors.initials: SS
authors.lastname: Najjar
mesh_terms: D000368:Aged; D000786:Anger / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011795:Surveys and Questionnaires; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography