title: Hostility and physiological responses to acute stress in people with type 2 diabetes.
abstract: OBJECTIVE
  Hostility is associated with cardiovascular mortality and morbidity, and one of the mechanisms may involve heightened reactivity to mental stress. However, little research has been conducted in populations at high risk for cardiovascular disease. The aim of the present study was to assess the relationship between hostility and acute stress responsivity in individuals with Type 2 diabetes.
  
  
  METHODS
  A total of 140 individuals (median age [standard deviation] 63.71 [7.00] years) with Type 2 diabetes took part in laboratory-based experimental stress testing. Systolic blood pressure, diastolic blood pressure, heart rate, plasma interleukin-6 (IL-6), and salivary cortisol were assessed at baseline, during two stress tasks, and 45 and 75 minutes later. Cynical hostility was assessed using the Cook Medley Cynical Hostility Scale.
  
  
  RESULTS
  Participants with greater hostility scores had heightened increases in IL-6 induced by the acute stress tasks (B = 0.082, p = .002), independent of age, sex, body mass index, smoking, household income, time of testing, medication, and baseline IL-6. Hostility was inversely associated with cortisol output poststress (B = -0.017, p = .002), independent of covariates. No associations between hostility and blood pressure or heart rate responses were observed.
  
  
  CONCLUSIONS
  Hostile individuals with Type 2 diabetes may be susceptible to stress-induced increases in inflammation. Further research is needed to understand if such changes increase the risk of cardiovascular disease in this population.
authors.affiliation: From the Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Hackett
authors.forename: Antonio I
authors.initials: AI
authors.lastname: Lazzarino
authors.forename: Livia A
authors.initials: LA
authors.lastname: Carvalho
authors.forename: Mark
authors.initials: M
authors.lastname: Hamer
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology* / Q000523:psychology*; D005260:Female; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000276:immunology* / Q000503:physiopathology*