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From the Brown University School of Medicine (R.N., S.M.B.), Providence, RI; University of Memphis Prevention Center (K.D.W.), Memphis, TN; Department of Psychology, Ohio State University (C.M.S.), Columbus, OH; Normative Aging Study, Boston VA Outpatient Clinic, and Department of Epidemiology and Biostatistics, Boston University School of Public Health (A.S.), Boston, MA; Department of Applied Behavioral Sciences, University of California at Davis (C.M.A.), Davis, CA; Department of Medicine, Evans Memorial Hospital, Northwestern University School of Medicine (L.L.), Northbrook, IL; and The Channing Laboratory, Brigham and Women’s Hospital and Harvard Medical School (S.T.W.), Boston, MA.
Address reprint requests to: Raymond Niaura, PhD, Center for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906.
OBJECTIVE: Several studies have shown that hostility, as measured by the Minnesota Multiphasic Personality Inventory–derived Cook-Medley Hostility Scale (Ho), is positively associated with several cardiovascular risk factors, possibly accounting for the relationship between Ho scores and cardiovascular mortality. This study was undertaken to examine associations between hostility and cardiovascular risk factors representing the metabolic syndrome in 1081 older men who participated in the Normative Aging Study.
METHODS: Subjects included men who completed the Minnesota Multiphasic Personality Inventory in 1986 and who participated in a subsequent laboratory examination within 1 to 4 years. Total and subscale Ho scores were computed, and associations with anthropometric data, cigarette smoking, dietary information, serum lipids, blood pressure, and fasting glucose and insulin levels were examined.
RESULTS: The total Ho score was positively associated with waist/hip ratio, body mass index, total caloric intake, fasting insulin level, and serum triglycerides. The Ho score was inversely related to education and high-density lipoprotein cholesterol concentration. Path analysis also suggested that the effects of hostility on insulin, triglycerides, and high-density lipoprotein cholesterol were mediated by its effects on body mass index and waist/hip ratio, which, in turn, exerted their effects on lipids and blood pressure through insulin.
CONCLUSIONS: The results are consistent with those of prior research and also suggest that, in older men, hostility may be associated with a pattern of obesity, central adiposity, and insulin resistance, which can exert effects on blood pressure and serum lipids. Furthermore, effects of hostility on the metabolic syndrome appear to be mediated by body mass index and waist/hip ratio.
Key Words: hostility • metabolic syndrome • men • lipids • insulin
Abbreviations: BMI = body mass index; CHD = coronary heart disease; DPB = diastolic blood pressure; HDL-C = high-densitylipoprotein cholesterol; Ho = Cook-Medley Hostility Scalescore; LDL-C = low-density lipoprotein cholesterol; MMPI = Minnesota Multiphasic Personality Inventory; SBP =systolic blood pressure; TRG = triglycerides; VLDL-C =very-low-density lipoprotein cholesterol; WHR = waist/hip ratio.
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