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Hostile Personality Traits and Coronary Artery Calcification in Middle-Aged and Older Married Couples: Different Effects for Self-Reports Versus Spouse Ratings

From the Department of Psychology (T.W.S., B.N.U., C.A.B., P.F., G.P., M.H.) and the Department of Internal Medicine (P.N.H.), University of Utah, Salt Lake City, Utah; Department of Radiology (H.-C.Y.), Kaiser Moanalua Medical Center, Honolulu, Hawaii.

Address correspondence and reprint requests to Timothy W. Smith, Department of Psychology, University of Utah, 380 South 1530 East (Room 502), Salt Lake City, UT 84112-0251. E-mail: tim.smith{at}psych.utah.edu

Objective: To examine the association between hostile personality traits and coronary artery disease (CAD) and the role of aspects of hostility, method of assessment, and age as influences on its magnitude, as prior studies of hostility and coronary artery calcification (CAC) have produced conflicting findings.

Methods: Participants included 300 married couples (mean age = 54.4 years) free from diagnosed CAD. Participants completed four measures of hostility—self-reports and spouse ratings of angry hostility (i.e., tendency to experience anger) and antagonism (i.e., argumentative, mistrusting, and cold interpersonal behavior).

Results: In hierarchical random regression models accounting for dependency between husbands' and wives' observations, analyses of log-transformed Agatston scores indicated that self-reports of angry hostility and antagonism were not related to CAC. However, spouse ratings of both anger and antagonism were significantly associated with CAC severity. Interactions with age indicated that these associations occurred only among older participants. Control of behavioral and biomedical risk factors did not eliminate these effects. Antagonism but not anger was an independent predictor of CAC when considered simultaneously.

Conclusions: Hostility is associated with concurrent asymptomatic CAD as assessed through CAC, but this effect is likely to be underestimated when hostility is assessed through self-reports rather than ratings by others and in samples with lower prevalence and severity of CAC.

Key Words: hostility • anger • antagonism • agreeableness • coronary artery calcification • coronary artery disease

Abbreviations: CAC = coronary artery calcification; CAD = coronary artery disease; CHD = coronary heart disease; CT = computed tomography.

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