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Expressive/Suppressive Anger-Coping Responses, Gender, and Types of Mortality: a 17-Year Follow-Up (Tecumseh, Michigan, 1971–1988)

From the Department of Epidemiology, School of Public Health (E.H., M.J.), Biostatistics, School of Public Health (M.A.S.), Psychology (E.H.), Internal Medicine (L.G.), and the Center for Human Growth and Development (N.K.), University of Michigan, Ann Arbor, Michigan.

Address reprint requests to: Ernest Harburg, PhD, 240 East 10th Street, #9B, New York, NY 10003–7702. Email: ernie{at}harburgfoundation.org

OBJECTIVES: This study examined prospectively (1971–1988) the relationship between anger-coping responses, gender, and mortality (N = 91) in a representative sample of men (N = 324) and women (N = 372), aged 30 to 69, from the Tecumseh Community Health Study.

METHODS: Anger-coping was measured by responses to hypothetical unfair anger-provoking situations. Cox proportional hazard regressions were used adjusted for seven health risk factors (age, smoking, relative weight, systolic blood pressure (SBP), bronchial problems, FEV₁, and cardiovascular (CV) risk).

RESULTS: Men’s suppressed anger interacted significantly with SBP and also with bronchial problems to predict both all-cause and CV mortality. Women showed direct relationships between suppressed anger and early mortality (all-cause, CV, and cancer). Women also showed an interaction of spouse-suppressed anger and SBP for all-cause and CV mortality. Data suggest men who expressed their anger died earlier of cancer (N = 16) deaths.

CONCLUSIONS: Suppressed anger at the time of an unjust attack may become chronic resentment (intermittent rage or hatred) about which little is known and requires research. The design for future research should experimentally measure both suppressed anger-coping responses (after an unfair attack) and morbidity (eg, blood pressure, bronchitis, immune disorder, etc.) to predict prospectively to earlier mortality.

Key Words: anger, • blood pressure, • cancer, • gender, • mortality.

Abbreviations: CV = cardiovascular;; FEV₁ = forced expiratory volume in 1 second;; LCES = Life Change Events Study;; SBP = systolic blood pressure;; TCHS = Tecumseh Community Health Study.

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