Annals of Behavioral Medicine

, Volume 20, Issue 2, pp 59–63 | Cite as

The relation of hostility to lipids and lipoproteins in women: Evidence for the role of antagonistic hostility

  • Edward C. Suarez
  • Michael P. Bates
  • Tina L. Harralson


We examined the relation of antagonistic, neurotic, and cynical hostility to lipids and lipoproteins in 77 healthy women (aged 18–26) selected for having high (>17) or low (<12) scores on the Cook-Medley Hostility (Ho) scale. Fasting lipids were determined during the luteal phase of the menstrual cycle for oral contraceptive (OC) non-users (N=41), and during pills 15–21 for OC users (N=36). Factor scores for antagonistic and neurotic hostility were derived from a principal component of the Buss-Durkee Hostility Inventory, Spielberger's Anger Expression, and the NEO-Personality Inventory. High Ho scores were significantly associated with higher cholesterol. Antagonistic hostility significantly predicted cholesterol, low density lipoprotein cholesterol, triglycerides, and the ratio of cholesterol to high density lipoprotein cholesterol, with higher antagonistic hostility scores associated with higher levels. Neurotic hostility did not predict lipids. Results suggest a potential pathophysiological mechanism that may contribute to the association between hostility and coronary heart disease. Moreover, a measure of antagonistic hostility, relative to cynical and neurotic hostility, was the best predictor of lipid levels.


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  1. (1).
    Smith TW: Hostility and health: Current status of psychosomatic hypothesis.Health Psychology. 1992,11: 139–150.PubMedCrossRefGoogle Scholar
  2. (2).
    Williams RB: A relook at personality type and coronary heart disease.Progressive Cardiology. 1991,4: 91–97.Google Scholar
  3. (3).
    Friedman M, Rosenman RH: Association of specific overt behavior pattern with blood and cardiovascular findings.Journal of the American Medical Association. 1959,169: 1286–1296.PubMedGoogle Scholar
  4. (4).
    Friedman M, Byers SO, Rosenman RH, et al: Coronary-prone individuals (Type A behavior pattern): Some biochemical characteristics.Journal of the American Medical Association. 1970,212: 1030–1037.PubMedCrossRefGoogle Scholar
  5. (5).
    Jenkins CD, Rosenman RH, Friedman M: Components of the coronary-prone behavior pattern: Their relation to silent myocardial infarction and blood lipids.Journal of Chronic Diseases. 1966,19: 599–609.PubMedCrossRefGoogle Scholar
  6. (6).
    Rosenman RH, Friedman M: Association of specific behavior pattern in women with blood and cardiovascular findings.Circulation. 1961,24: 1173–1184.PubMedGoogle Scholar
  7. (7).
    Niaura R, Stoney CM, Herbert PN: Lipids in psychological research: The last decade.Biological Psychology. 1992,34: 1–43.PubMedCrossRefGoogle Scholar
  8. (8).
    Siegler IC: Hostility and risk: Demographic and lifestyle variables. In Siegman AW, Smith TW (eds),Anger, Hostility and the Heart. Hillsdale, NJ: Lawrence Erlbaum Associates, 1994, 199–214.Google Scholar
  9. (9).
    Dujovne VF, Houston BK: Hostility-related variables and plasma lipid levels.Journal of Behavioral Medicine. 1991,14: 555–565.PubMedCrossRefGoogle Scholar
  10. (10).
    Fowkes FGR, Leng GC, Donnan PT, et al: Serum cholesterol, triglycerides, and aggression in the general population.Lancet. 1992,340: 995–998.PubMedCrossRefGoogle Scholar
  11. (11).
    Lundberg U, Hedman M, Melin B, Frankenhaeuser M: Type A behavior in healthy males and females as related to physiological reactivity and blood lipids.Psychosomatic Medicine. 1989,51: 113–122.PubMedGoogle Scholar
  12. (12).
    Niaura R, Stoney CM, Ward K, et al: Hostility and cardiovascular disease risk in older males: The Normative Aging Study (Abstract).Psychosomatic Medicine. 1994,56: 147.Google Scholar
  13. (13).
    Scanlan JM, Myers CD, Werner JJ, et al: Hostility and cardiovascular risk factors: Interaction with sex and health habits (Abstract).Psychosomatic Medicine. 1994,56: 147.Google Scholar
  14. (14).
    Sloane RB, Habib A, Eveson MD, Payne RW: Some behavioral and other correlates of cholesterol metabolism.Journal of Psychosomatic Research. 1991,5: 183–186.CrossRefGoogle Scholar
  15. (15).
    Weidner G, Sexton G, McLellarn R, et al: The role of Type A behavior and hostility in an elevation of plasma lipids in adult women and men.Psychosomatic Medicine. 1987,49: 136–145.PubMedGoogle Scholar
  16. (16).
    Almada SJ, Zonderman AB, Shekelle RB, et al: Neuroticism and cynicism and risk of death in middle-aged men: The Western Electric Study.Psychosomatic Medicine. 1991,53: 165–175.PubMedGoogle Scholar
  17. (17).
    Niaura R, Herbert P: Hostility and blood lipids in healthy adults. The 12th Annual Meeting of the Society of Behavioral Medicine. Washington, DC: March, 1991.Google Scholar
  18. (18).
    Scherwitz LW, Perkins LL, Chesney MA, et al: Hostility and health behaviors in young adults: The CARDIA Study.American Journal of Epidemiology. 1992,136: 136–145.PubMedGoogle Scholar
  19. (19).
    Shekelle RB, Gale M, Ostfeld AM, Paul O: Hostility, risk of coronary heart disease, and mortality.Psychosomatic Medicine. 1983,45: 109–114.PubMedGoogle Scholar
  20. (20).
    Barefoot JC, Lipkus IM: Assessment of anger-hostility. In Siegman AW, Smith TW (eds),Anger, Hostility and the Heart. Hillsdale, NJ: Lawrence Erlbaum Associates, 1993, 43–66.Google Scholar
  21. (21).
    Musante L, MacDougall JM, Dembroski TM, Costa PT: Potential for hostility and dimensions of anger.Health Psychology. 1989,8: 343–354.PubMedCrossRefGoogle Scholar
  22. (22).
    Dujovne VF, Houston BK, Dujovne CA: Type A behavior, anger expression, and plasma lipid levels: A preliminary study.Coronary Artery Disease. 1992,3: 1171–1176.Google Scholar
  23. (23).
    Buss AH, Durkee A: An inventory for assessing different kinds of hostility.Journal of Cosulting Psychology. 1957,42: 155–162.Google Scholar
  24. (24).
    Smith TW, Frohm KD: What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale.Health Psychology. 1985,4: 503–520.PubMedCrossRefGoogle Scholar
  25. (25).
    Kim HJ, Kalkhoff RK: Changes in lipoprotein composition during the menstrual cycle.Metabolism. 1979,28: 663–668.PubMedCrossRefGoogle Scholar
  26. (26).
    Siegman AW, Dembroski TM, Ringel N: Components of hostility and the severity of coronary artery disease.Psychosomatic Medicine. 1987,49: 127–135.PubMedGoogle Scholar
  27. (27).
    Spielberger CD, Johnson EH, Russell SF, et al: The experience and expression of anger: Construction and validation of an anger expression scale. In Chesney MA, Rosenman RH (eds),Anger and Hostility in Cardiovascular and Behavioral Disorders. Washington, DC: Hemisphere Publishing Company, 1985, 5–30.Google Scholar
  28. (28).
    Costa PT, McCrae RR:The NEO Personality Inventory. Odessa, FL: Psychological Assessment Resources, 1985.Google Scholar
  29. (29).
    Dembroski TM, Costa PT: Coronary-prone behavior: Components of the Type A pattem and hostility.Journal of Personality. 1987,55: 212–235.CrossRefGoogle Scholar
  30. (30).
    SAS Institute, Inc:SAS User's Guide: Statistics, Version 5 edition. Cary, NC: SAS Institute, Inc., 1985.Google Scholar
  31. (31).
    Suarez EC, Williams RB: The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics.Psychosomatic Medicine. 1990,52: 558–570.PubMedGoogle Scholar
  32. (32).
    Suarez EC, Harlan E, Peoples MC, Williams RB: Cardiovascular and emotional responses in women: The role of hostility and harassment.Health Psychology. 1993,12: 459–468.PubMedCrossRefGoogle Scholar
  33. (33).
    Barefoot JC, Dodge KA, Peterson BL, Dahlstrom WG, Williams RB: The Cook-Medley Hostility Scale: Item content and ability to predict survival.Psychosomatic Medicine. 1989,51: 46–57.PubMedGoogle Scholar
  34. (34).
    Brindley DN, McCann BS, Niaura R, Stoney CM, Suarez EC: Stress and lipoprotein metabolism: Modulators and mechanisms.Metabolism. 1993,42: 3–15.PubMedCrossRefGoogle Scholar
  35. (35).
    Dimsdale JE, Herd JA, Hartley LH: Epinephrine-mediated increases in plasma cholesterol.Psychosomatic Medicine. 1983,45: 227–232.PubMedGoogle Scholar
  36. (36).
    Suarez EC, Williams RB, Kuhn CM, et al: Biobehavioral basis of coronary-prone behavior in middle-aged men. Part II. Serum cholesterol, the Type A behavior pattern, and hostility as interactive modulators of physiological reactivity.Psychosomatic Medicine. 1991,53: 528–537.PubMedGoogle Scholar
  37. (37).
    Suarez EC, Harralson TL, Bates MP, Tyrey M, McNeer TCC: Neuroendocrine responses are associated with lipids in hostile women (Abstract).Psychosomatic Medicine. 1995,57: 92.Google Scholar
  38. (38).
    Siegler IC, Peterson BL, Barefoot JC, Williams RB: Hostility during late adolescence predicts coronary risk factors at midlife.American Journal of Epiaemiology. 1992,136: 146–154.Google Scholar

Copyright information

© The Society of Behavioral Medicine 1998

Authors and Affiliations

  • Edward C. Suarez
    • 1
  • Michael P. Bates
    • 1
  • Tina L. Harralson
    • 1
  1. 1.Duke University Medical CenterDurham

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