Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: A prospective study in the normative aging study
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Background: Anger, anxiety, and depression have each been identified as risk factors for coronary heart disease (CHD). Whether the apparent risk is a function of unique aspects of each emotion or due to a shared underlying dimension of negative affectivity is unclear.Purpose: The goal of this study was to assess shared and unique contributions of anger, anxiety, and depression to incidentCHD. Methods: Data are from the Veterans Administration Normative Aging Study, an ongoing cohort of older men. Measures of anger, anxiety, and depression were obtained from 1,306 men completing the revised Minnesota Multiphasic Personality Inventory in 1986. From these measures we derived three nearorthogonal scales termed iso(lated)-anger, iso-anxiety, and iso-depression and a fourth scale measuring general distress.Results: During an average of 10.9 years of follow-up, 161 cases of incident CHD occurred. When considered individually, iso-anxiety, iso-anger, and shared general distress were each associated with CHD risk. When all emotions were considered simultaneously, only iso-anxiety and shared general distress were associated with incidentCHD. Conclusions: Considering shared versus unique aspects of negative emotions may clarify the nature of their apparent toxicity in relation toCHDsrisk. General distress shared across negative emotions is an important component in the emotionCHD relation. Aspects of anxiety may also independently increaseCHD risk.
- Rozanski A, Blumenthal JA, Davidson KW, Saab P, Kubzansky LD: The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: The emerging field of behavioral cardiology.Journal of American College of Cardiology. 2005,45:637–651. CrossRef
- Stansfeld SA, Marmot M, (eds):Stress and the Heart: Psychosocial Pathways to Coronary Heart Disease. London: BMJ, 2002.
- Haines AP, Imeson JD, Meade TW: Phobic anxiety and ischaemic heart disease.British Medical Journal (Clinical Research Ed.) 1987,295:297–299.
- Rugulies R: Depression as a predictor for coronary heart disease.American Journal of Preventive Medicine. 2002,23:51–61. CrossRef
- Williams JE, Paton CC, Siegler IC, et al.: Anger proneness predicts coronary heart disease risk: Prospective analysis from the Atherosclerosis Risk in Communities (ARIC) Study.Circulation. 2000,101:2034–2039.
- Todaro JF, Shen BJ, Niaura R, Spiro A, Ward KD: Effect of negative emotions on frequency of coronary heart disease (the Normative Aging Study).American Journal of Cardiology. 2003,92:901–906. CrossRef
- Suls J, Bunde J: Anger, anxiety, and depression as risk factors for cardiovascular disease: The problems and implications of overlapping affective dispositions.Psychological Bulletin. 2005,131:260–300. CrossRef
- Frasure-Smith N, Lesperance F: Depression and other psychological risks following myocardial infarction.Archives of General Psychiatry. 2003,60:627–636. CrossRef
- Rosengren A, Hawken S, Ounpuu S, et al.: Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): Case-control study.The Lancet. 2004,364:953–962. CrossRef
- Denollet J, Sys SU, Stroobant N, et al.: Personality as an independent predictor of long-term mortality in patients with coronary heart disease [See comments].The Lancet. 1996,347:417–421. CrossRef
- Stansfeld SA, Fuhrer R, Shipley MJ, Marmot MG: Psychological distress as a risk factor for coronary heart disease in the Whitehall II study.International Journal of Epidemiology. 2002,31:248–255. CrossRef
- Ketterer MW: Anger and myocardial infarction [Letter].Circulation. 1996,94:1788–1789.
- Carney RM: Psychological risk factors for cardiac events: Could there be just one?Circulation. 1998,97:128–129.
- Lazarus RS:Emotion and Adaptation. New York: Oxford University Press, 1991.
- Bell B, Rose CI, Damon A: The Normative Aging Study: An interdisciplinary and longitudinal study of health and aging.International Journal of Aging and Human Development. 1972,3:5–17.
- Butcher JN, Dahlstrom WG, Graham JR, Tellegen A, Kaemmer B:MMPI-2: Minnesota Multiphasic Personality Inventory—2.Manual for Administration and Scoring. Minneapolis: University of Minnesota Press, 1989.
- Shurtleff D:Some Characteristics Related to the Incidence of Cardiovascular Disease and Death: Framingham Study, 18-Year Follow-Up. Bethesda, MD: U.S. Department of Health, Education and Welfare, 1974.
- U.S. Department of Health, Education and Welfare:International Classification of Diseases Adapted for Use in the United States (8th Rev.). Washington, DC: U.S. Department of Health, Education and Welfare, 1963.
- SAS Institute:SAS/STAT User’s Guide (Version 6, 4th Ed.). Cary, NC: SAS Institute, 1990.
- Kline P:An Easy Guide to Factor Analysis. New York: Routledge, 1994.
- Watson D, Clark LA, Tellegen A: Development and validation of brief measures of positive and negative affect: The PANAS scales.Journal of Personality and Social Psychology. 1988,54:1063–1070. CrossRef
- Sesso HD, Kawachi I, Vokonas PS, Sparrow D: Depression and the risk of coronary heart disease in the Normative Aging Study.American Journal of Cardiology. 1998,82:851–856. CrossRef
- Kawachi I, Sparrow D, Spiro A, Vokonas P, Weiss ST: A prospective study of anger and coronary heart disease: The Normative Aging Study.Circulation. 1996,94:2090–2095.
- Berry WD, Feldman S:Multiple Regression in Practice (8th Ed.). Newbury Park, CA: Sage, 1985.
- Davidson KW, Rieckmann N, Rapp M: Definitions and distinctions among depressive syndromes and symptoms: Implications for a better understanding of the depression-cardiovascular disease association.Psychosomatic Medicine. 2005,67:S6-S9. CrossRef
- Kubzansky LD, Kawachi I: Going to the heart of the matter: Do negative emotions cause coronary heart disease?Journal of Psychosomatic Research. 2000,48:323–337. CrossRef
- Kamarck T, Jennings JR: Biobehavioral factors in sudden cardiac death.Psychological Bulletin. 1991,109:42–75. CrossRef
- Friedman BH, Thayer JF: Anxiety and autonomic flexibility: A cardiovascular approach.Biological Psychology. 1998,49:303–323. CrossRef
- Paterniti S, Zureik M, Ducimetiere PJT, Feve JM, Alperovitch A: Sustained anxiety and 4-year progression of carotid atherosclerosis.Arteriosclerosis Thrombosis and Vascular Biology. 2001,21:136–141.
- Rozanski A, Blumenthal JA, Kaplan J: Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy.Circulation. 1999,99:2192–2217.
- Weissman MM: The epidemiology of anxiety disorders: Rates, risks and familiar patterns. In Tuma AH, Maser JD (eds),Anxiety and the Anxiety Disorders. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1985.
- Barlow DH:Anxiety and Its Disorders. New York: Guilford, 1988.
- Gallo LC, Matthews KA: Understanding the association between socioeconomic status and physical health: Do negative emotions play a role? Psychological Bulletin. 2003,129:10–51. CrossRef
- Glass TA.: Psychosocial intervention. In Berkman LF, Kawachi I (eds),Social Epidemiology. New York: Oxford University Press, 2000, 267–305.
- Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: A prospective study in the normative aging study
Annals of Behavioral Medicine
Volume 31, Issue 1 , pp 21-29
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, 02115, Boston, MA
- 2. Department of Veterans Affairs Medical Center, Normative Aging Study, USA
- 3. Boston University School of Medicine, USA
- 4. Johns Hopkins Bloomberg School of Public Health, USA
- 5. Department of Veterans Affairs Medical Center, Channing Laboratory and Harvard Medical School Normative Aging Study, USA
- 6. Boston University School of Medicine, USA