Anger, hostility and risk of stroke: a meta-analysis of cohort studies



A growing number of studies have been conducted on the relationship between anger and hostility and the risk of stroke, and their conclusions are not consistent. Accordingly, we performed a meta-analysis to evaluate the relationship between anger and hostility and the risk of stroke.


We searched the PubMed and Embase databases for cohort studies, focusing on the relationship between anger and hostility and risk of stroke. Then studies were selected according to the inclusion and exclusion criteria. Study results were pooled using a random effects model.


Ten studies from seven articles involving 52,277 participants were included in this meta-analysis. No significant association was found between anger and hostility level and risk of stroke (hazard ratio 1.08; 95% confidence interval 0.79–1.47). However, a positive association was seen when people with high socioeconomic status were excluded (hazard ratio 1.30; 95% confidence interval 1.06–1.59).


A higher level of anger and hostility is not associated with elevated risk of stroke. However, the association is positive among people with lower socioeconomic status.

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This work was supported by a National Science and Technology Major Project (2017ZX10201101) and a China Medical University Major Clinical Medicine Construction Project in 2018 (111-3110118036).

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Correspondence to Li Tian or Weiyu Teng.

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Chen, H., Zhang, B., Xue, W. et al. Anger, hostility and risk of stroke: a meta-analysis of cohort studies. J Neurol 266, 1016–1026 (2019).

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  • Stroke
  • Anger
  • Hostility
  • Cohort studies
  • Meta-analysis