Abstract
We investigated the associations of anger and cynicism with carotid artery intima-media thickness (IMT) and whether these associations were moderated by childhood or adulthood socioeconomic status (SES). The participants were 647 men and 893 women derived from the population-based Cardiovascular Risk in Young Finns Study. Childhood SES was measured in 1980 when the participants were aged 3–18. In 2001, adulthood SES, anger, cynicism, and IMT were measured. There were no associations between anger or cynicism and IMT in the entire population, but anger was associated with thicker IMT in participants who had experienced low SES in childhood. This association persisted after adjustment for a host of cardiovascular risk factors. It is concluded that the ill health-effects of psychological factors such as anger may be more pronounced in individuals who have been exposed to adverse socioeconomic circumstances early in life.
Similar content being viewed by others
References
Åkerblom, H. K., Uhari, M., Pesonen, E., Dahl, M., Kaprio, E. A., Nuutinen, E. M., Pietikäinen, M., Salo, M. K., Aromaa, A., Kannas, L., Keltikangas-Järvinen, L., Kuusela, V., Räsänen, L., Rönnemaa, T., Knip, M., Telama, R., Välimäki, I., Pyörälä, K., & Viikari, J. (1991). Cardiovascular risk in young Finns. Annals of Medicine, 23, 35–39.
Barefoot, J. C., Dodge, K. A., Peterson, B. L., Dahlstrom, W. G., & Williams, R. B., Jr. (1989). The Cook-Medley Hostility scale: Item content and ability to predict survival. Psychosomatic Medicine, 51, 46–57.
Björntorp, P. (1991). Visceral fat accumulation: The missing link between psychosocial factors and cardiovascular disease? Journal of Internal Medicine, 230, 195–201.
Bleil, M. E., McCaffery, J. M., Muldoon, M. F., Sutton-Tyrrell, K., & Manuck, S. B. (2004). Anger-related personality traits and carotid artery atherosclerosis in untreated hypertensive men. Psychosomatic Medicine, 66, 633–639.
Blumenthal, J. A., Burg, M. M., Barefoot, J., Williams, R. B., Haney, T., & Zimet, G. (1987). Social support, type A behavior, and coronary artery disease. Psychosomatic Medicine, 49, 331–340.
Bots, M. L., Hoes, A. W., Koudstaal, P. J., Hofman, A., & Grobbee, D. E. (1997). Common carotid intima-media thickness and risk of stroke and myocardial infarction: The Rotterdam Study. Circulation, 96, 1432–1437.
Bradley, R. H., & Corwyn, R. F. (2002). Socioeconomic status and child development. Annual Review of Psychology, 53, 371–399.
Burke, G. L., Evans, G. W., Riley, W. A., Sharrett, A. R., Howard, G., Barnes, R. W., Rosamond, W., Crow, R. S., Rautaharju, P. M., & Heiss, G. (1995). Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults: The Atherosclerosis Risk in Communities (ARIC) Study. Stroke, 26, 386–391.
Buss, A. H. (1991). The EAS theory of temperament. In Strelau, J. & Angleitner, A. (Eds.), Explorations in temperament: International perspectives on theory and measurement (pp. 43–60). New York: Plenum Press.
Buss, A. H., & Durkee, A. (1957). An inventory for assessing different kinds of hostility. Journal of Consulting Psychology, 21, 343–349.
Chambless, L. E., Heiss, G., Folsom, A. R., Rosamond, W., Szklo, M., Sharrett, A. R., & Clegg, L. X. (1997). Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: The Atherosclerosis Risk in Communities (ARIC) Study, 1987–1993. American Journal of Epidemiology, 146, 483–494.
Chang, P. P., Ford, D. E., Meoni, L. A., Wang, N. Y., & Klag, M. J. (2002). Anger in young men and subsequent premature cardiovascular disease: The Precursors Study. Archives of Internal Medicine, 162, 901–906.
Comrey, A. L. (1957). A factor analysis of items on the MMPI hysteria scale. Educational and Psychological Measurement, 17, 586–592.
Comrey, A. L. (1958). A factor analysis of items on the MMPI paranoia scale. Educational and Psychological Measurement, 18, 99–107.
Eng, P. M., Fitzmaurice, G., Kubzansky, L. D., Rimm, E. B., & Kawachi, I. (2003). Anger expression and risk of stroke and coronary heart disease among male health professionals. Psychosomatic Medicine, 65, 100–110.
Everson-Rose, S. A., Lewis, T. T., Karavolos, K., Matthews, K. A., Sutton-Tyrrell, K., & Powell, L. H. (2006). Cynical hostility and carotid atherosclerosis in African American and white women: The Study of Women’s Health Across the Nation (SWAN) Heart Study. American Heart Journal, 152, 982.e7–982.e13.
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry, 18, 499–502.
Gallo, L. C., & Matthews, K. A. (2003). Understanding the association between socioeconomic status and physical health: Do negative emotions play a role? Psychological Bulletin, 129, 10–51.
Greenglass, E. R., & Julkunen, J. (1989). Construct validity and sex differences in Cook-Medley Hostility. Personality and Individual Differences, 10, 209–218.
Gump, B. B., Matthews, K. A., & Räikkönen, K. (1999). Modeling relationships among socioeconomic status, hostility, cardiovascular reactivity, and left ventricular mass in African American and white children. Health Psychology, 18, 140–150.
Heiss, G., Sharrett, A. R., Barnes, R., Chambless, L. E., Szklo, M., & Alzola, C. (1991). Carotid atherosclerosis measured by B-mode ultrasound in populations: Associations with cardiovascular risk factors in the ARIC study. American Journal of Epidemiology, 134, 250–256.
Julkunen, J., Salonen, R., Kaplan, G. A., Chesney, M. A., & Salonen, J. T. (1994). Hostility and the progression of carotid atherosclerosis. Psychosomatic Medicine, 56, 519–525.
Juonala, M., Viikari, J. S., Hutri-Kähönen, N., Pietikäinen, M., Jokinen, E., Taittonen, L., Marniemi, J., Rönnemaa, T., & Raitakari, O. T. (2004). The 21-year follow-up of the Cardiovascular Risk in Young Finns Study: Risk factor levels, secular trends and east-west difference. Journal of Internal Medicine, 255, 457–468.
Kawachi, I., Sparrow, D., Spiro, A. 3rd., Vokonas, P., & Weiss, S. T. (1996). A prospective study of anger and coronary heart disease: The Normative Aging Study. Circulation, 94, 2090–2095.
Keltikangas-Järvinen, L., & Ravaja, N. (2002). Relationships between hostility and physiological coronary heart disease risk factors in young adults: Moderating influence of perceived social support and sociability. Psychology & Health, 17, 173–190.
Knox, S. S., Adelman, A., Ellison, R. C., Arnett, D. K., Siegmund, K., Weidner, G., & Province, M. A. (2000). Hostility, social support, and carotid artery atherosclerosis in the National Heart, Lung, and Blood Institute Family Heart Study. American Journal of Cardiology, 86, 1086–1089.
Koskenvuo, M., Kaprio, J., Rose, R. J., Kesäniemi, A., Sarna, S., Heikkilä, K., & Langinvainio, H. (1988). Hostility as a risk factor for mortality and ischemic heart disease in men. Psychosomatic Medicine, 50, 330–340.
Kraemer, H. C., Stice, E., Kazdin, A., Offord, D., & Kupfer, D. (2001). How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American Journal of Psychiatry, 158, 848–856.
Lynch, J. W., Everson, S. A., Kaplan, G. A., Salonen, R., & Salonen, J. T. (1998). Does low socioeconomic status potentiate the effects of heightened cardiovascular responses to stress on the progression of carotid atherosclerosis? American Journal of Public Health, 88, 389–394.
Matsumoto, Y., Uyama, O., Shimizu, S., Michishita, H., Mori, R., Owada, T., & Sugita, M. (1993). Do anger and aggression affect carotid atherosclerosis? Stroke, 24, 983–986.
Matthews, K. A., Owens, J. F., Kuller, L. H., Sutton-Tyrrell, K., & Jansen-McWilliams, L. (1998). Are hostility and anxiety associated with carotid atherosclerosis in healthy postmenopausal women? Psychosomatic Medicine, 60, 633–638.
McEwen, B. S. (2000). Allostasis and allostatic load: Implications for neuropsychopharmacology. Neuropsychopharmacology, 22, 108–124.
Mendes de Leon, C. F. (1992). Anger and impatience/irritability in patients of low socioeconomic status with acute coronary heart disease. Journal of Behavioral Medicine, 15, 273–284.
Mittleman, M. A., Maclure, M., Nachnani, M., Sherwood, J. B., & Muller, J. E. (1997). Educational attainment, anger, and the risk of triggering myocardial infarction onset. Archives of Internal Medicine, 157, 769–775.
Moreno, J. K., Fuhriman, A., & Selby, M. J. (1993). Measurement of hostility, anger, and depression in depressed and nondepressed subjects. Journal of Personality Assessment, 61, 511–523.
Pollitt, R. A., Daniel, M., Kaufman, J. S., Lynch, J. W., Salonen, J. T., & Kaplan, G. A. (2005). Mediation and modification of the association between hopelessness, hostility, and progression of carotid atherosclerosis. Journal of Behavioral Medicine, 28, 53–64.
Power, C., Matthews, S., & Manor, O. (1998). Inequalities in self-rated health: Explanations from different stages of life. Lancet, 351, 1009–1014.
Pulkki, L., Keltikangas-Järvinen, L., Ravaja, N., & Viikari, J. (2003). Child-rearing attitudes and cardiovascular risk among children: Moderating influence of parental socioeconomic status. Preventive Medicine, 36, 55–63.
Pulkki, L., Kivimäki, M., Elovainio, M., Viikari, J., & Keltikangas-Järvinen, L. (2003). Contribution of socioeconomic status to the association between hostility and cardiovascular risk behaviors: A prospective cohort study. American Journal of Epidemiology, 158, 736–742.
Pulkki-Råback, L., Elovainio, M., Kivimäki, M., Raitakari, O. T., & Keltikangas-Järvinen, L. (2005). Temperament in childhood predicts body mass in adulthood: The Cardiovascular Risk in Young Finns Study. Health Psychology, 24, 307–315.
Räikkönen, K., Matthews, K. A., Sutton-Tyrrell, K., & Kuller, L. H. (2004). Trait anger and the metabolic syndrome predict progression of carotid atherosclerosis in healthy middle-aged women. Psychosomatic Medicine, 66, 903–908.
Raitakari, O. T., Juonala, M., Kähönen, M., Taittonen, L., Laitinen, T., Mäki-Torkko, N., Järvisalo, M. J., Uhari, M., Jokinen, E., Rönnemaa, T., Åkerblom, H. K., & Viikari, J. S. (2003). Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: The Cardiovascular Risk in Young Finns Study. The Journal of American Medical Association, 290, 2277–2283.
Ranjit, N., Diez-Roux, A. V., Chambless, L., Jacobs, D. R., Jr., Nieto, F. J., & Szklo, M. (2006). Socioeconomic differences in progression of carotid intima-media thickness in the Atherosclerosis Risk in Communities Study. Arteriosclerosis, Thrombosis, and Vascular Biology, 26, 411–416.
Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: Family social environments and the mental and physical health of offspring. Psychological Bulletin, 128, 330–366.
Rosvall, M., Östergren, P. O., Hedblad, B., Isacsson, S. O., Janzon, L., & Berglund, G. (2002). Life-course perspective on socioeconomic differences in carotid atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, 22, 1704–1711.
Rozanski, A., Blumenthal, J. A., & Kaplan, J. (1999). Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation, 99, 2192–2217.
Smith, T. W., Glazer, K., Ruiz, J. M., & Gallo, L. C. (2004). Hostility, anger, aggressiveness, and coronary heart disease: An interpersonal perspective on personality, emotion, and health. Journal of Personality, 72, 1217–1270.
Statistics Finland. (2005). Education statistics. Retrieved October 31, 2006, from http://www.stat.fi/tup/suoluk/suoluk_koulutus_en.html
Strike, P. C., & Steptoe, A. (2004). Psychosocial factors in the development of coronary artery disease. Progress in Cardiovascular Diseases, 46, 337–347.
Suarez, E. C., & Williams, R. B., Jr. (1990). The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics. Psychosomatic Medicine, 52, 558–570.
Telama, R., Yang, X., Viikari, J., Välimäki, I., Wanne, O., & Raitakari, O. (2005). Physical activity from childhood to adulthood: A 21-year tracking study. American Journal of Preventive Medicine, 28, 267–273.
Treiber, F. A., Kamarck, T., Schneiderman, N., Sheffield, D., Kapuku, G., & Taylor, T. (2003). Cardiovascular reactivity and development of preclinical and clinical disease states. Psychosomatic Medicine, 65, 46–62.
Williams, J. E., Paton, C. C., Siegler, I. C., Eigenbrodt, M. L., Nieto, F. J., & Tyroler, H. A. (2000). Anger proneness predicts coronary heart disease risk: Prospective analysis from the Atherosclerosis Risk in Communities (ARIC) Study. Circulation, 101, 2034–2039.
Acknowledgments
This study was supported by the Academy of Finland (Grant no. 111056, 209514, and 209518 (LK-J), and 77841 and 210283 (OTR)), The Finnish Foundation of Cardiovascular Research and The Yrjö Jahnsson Foundation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Merjonen, P., Pulkki-Råback, L., Puttonen, S. et al. Anger is associated with subclinical atherosclerosis in low SES but not in higher SES men and women. The Cardiovascular Risk in Young Finns Study. J Behav Med 31, 35–44 (2008). https://doi.org/10.1007/s10865-007-9131-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-007-9131-6