Losing Hostility Makes Heart Patients Healthier

Heart patients who are hostile can become healthier by improving their attitude, new research shows.

Scientists from Ben-Gurion University, Israel, the University of Alabama and Dalhousie University, Halifax, Nova Scotia, Canada studied the effectiveness of an intervention aimed strictly at hostility reduction in patients with coronary heart disease. In the study, heart patients who jettisoned at least some of their hostility reduced their blood pressure as well. Since elevated blood pressure is a risk factor for heart disease, this finding could have significance for health providers.

"Most behavioral research with heart patients concentrates on the classic Type A personality," said Yori Gidron, PhD, head of the study. "But hostility may be the Type A character's most toxic component."

Twenty-two men who were coronary heart disease patients that scored high on hostility tests were split into two groups, a control group and an intervention group. The results of the study appear in the current issue of Health Psychology.

Members of the control group attended one class on hostility and its link with heart disease. The intervention group attended eight weekly meetings, 90 minutes each. Participants learned listening skills to help reduce antagonism, and techniques to avoid cynicism and anger. They were asked to keep daily logs of hostile feelings and their responses to them.

At the start of the study, the diastolic blood pressures averaged 90.3 in the intervention group and 88.9 in the control group, statistically similar. Levels of 90 or higher often are associated with strokes or heart attacks. The researchers reassessed participants after they completed their hostility reduction programs. A final follow-up occurred two months later.

Patients who attended the full, eight-session course reported at both reassessments, and were observed at final follow-up, to be less hostile than the other patients. They also had lower blood pressure immediately after the hostility programs. Members of the intervention group blood pressure averaged 85.2, versus the control group average of 94.4. Two months later, the difference was even greater, 81.8 versus 95.0.

Reductions in hostility were positively correlated with reductions in resting blood pressure. Given the study's design, this suggests that hostility may have a causal role in blood pressure.

The Cardiac Prevention Research Center, Halifax, Nova Scotia, Canada, funded this work.

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Health Psychology is the official, peer-reviewed research journal of the Division of Health Psychology (Division 38), American Psychological Association. For information about the journal, please contact its editor, David Krantz, PhD, at 301-295-3273.