Epidemiologic evidence suggests healthy individuals characterised by hostile personalities are at increased risk for coronary heart disease (CHD).¹ We tested if hostility predicts CHD recurrence differentially for men and women.

METHODS

Using the Nova Scotia Health Survey 1995 (NSHS95), a population based, prospective survey of 3227 community dwelling, outpatient Nova Scotian adults,² we examined participants with CHD at survey baseline. Of the NSHS95 participants, 227 (139 men, 88 women), 7% of the NSHS95 sample, had baseline CHD, determined by query of the provincial health registry for previous CHD discharges (diagnoses of ICD-9-CM codes 410-414) during the five years preceding survey enrolment. Of these 227 participants, 206 (91%) had complete hostility data (Cook-Medley hostility scale³), constituting our sample (128 men, 78 women). Other variables measured at survey baseline included age, sex, smoking status (never smoked/abstinence > 1 year versus current/abstinence < 1 year), physical activity, family history of early CHD, alcohol consumption (yes/no), education, diabetes (present/absent), blood pressure (analysed continuously), body mass index (BMI, kg/m²) (continuous), fasting lipids, depression (Center for Epidemiological Studies–Depression (CES-D) scale, scored < 16/⩾ 16), and social support (analysed continuously using a self report questionnaire⁴). With the exception of older age, the 21 participants with established CHD, but without baseline hostility scores, did not differ from those with hostility data (78 and 69 years, p  =  0.002). Hostility scores were dichotomised based on the sex specific median (men  =  21 (⩾ 21/< …