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Hostility is an independent predictor of recurrent coronary heart disease events in men but not women: results from a population based study
  1. D C Haas1,
  2. W F Chaplin2,
  3. D Shimbo3,
  4. T G Pickering3,
  5. M Burg3,
  6. K W Davidson1,*
  1. 1The Zena and Michael A Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, USA
  2. 2Department of Psychology, St John’s University, New York, USA
  3. 3The Behavioral Cardiovascular Health and Hypertension Program, Columbia University Medical Center, New York, USA
  1. Correspondence to:
    Donald C Haas
    MD, MPH, The Zena and Michael A Cardiovascular Institute, Mount Sinai School of Medicine, One Gustave L Levy Place, Box 1030, New York, NY 10029, USA;

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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.


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/< …

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  • * Also at The Behavioral Cardiovascular Health and Hypertension Program, Columbia University Medical Center, New York