Angry words can be deadly as 'sticks & stones

October 27, 1998

Researchers Link High Cholesterol, Expressed Hostility

People who have "antagonistic hostility", the sort that is expressed angrily, either verbally or physically, are likely to have high levels of cholesterol, new research shows.

Hostility and high levels of cholesterol have previously been associated, but Edward C. Suarez, PhD, and colleagues at Duke University Medical Center have now charted the differences among types of hostility and the risk of cardiovascular disease they pose.

Cynics and neurotics hostile types who feel angry but seldom take it out on others, are less at risk for high cholesterol than their "up-front-and-in-your face" counterparts, the research team reports in a current issue of Annals of Behavioral Medicine (Vol. 20, No. 2).

"The findings suggest that only certain aspects of hostility, characterized by an outward expression of anger in a verbal or physical manner and an antagonistic interpersonal style, are potentially coronary prone," they write.

Elevated blood lipids, such as cholesterol and triglycerides, link such behavior to health problems.

The scientists evaluated 77 healthy women, ages 18 to 26, about 94 percent of them white. (Hispanics comprised 4 percent, and Asian-Americans, 1 percent.) Participants were limited to those who posted high or low scores on a 50-item, true-or-false, hostility survey shown to be associated with increased coronary risk in men and women.

Questionnaires yielded details about types of hostility by assessing frequency of expressed and suppressed anger, levels of resentment and suspicion, personality traits, and factors.

Hostile women had significantly greater amounts of total cholesterol and low density lipoprotein cholesterol ("bad" cholesterol), but the correlation varied by type of hostility. Antagonistic hostility was the strongest predictor of cardiovascular risk factors, while neurotic hostility was not at all associated with them. In other words, the expression of anger mattered more than the experience of it.

The researchers note that hostile people in general often behave in ways that contribute to elevated lipids. Among other factors, many smoke (although this study excluded smokers) and ingest excess calories.

The Duke University study focused on the nature of the hostility associated with elevated lipids, not on what links the two. It also was limited to healthy young women. The scientists suspect that the antagonistic hostility pattern also holds true for older women.
The study was supported by a grant from the National Heart, Lung and Blood Institute.

Annals of Behavioral Medicine is the official peer-reviewed publication of The Society of Behavioral Medicine. For information about the journal, contact editor Arthur Stone, PhD, 516-632-8833.

Posted by the Center for the Advancement of Health For information about the Center contact Richard Hebert at (202) 387-2829.

Center for Advancing Health

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