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Hostility and Platelet Reactivity in Individuals Without a History of Cardiovascular Disease Events

From the Center for Behavioral Cardiovascular Health (D.S., S.K. L.T.W., D.A., M.M.B.), Division of General Medicine, Columbia University Medical Center, New York, New York; Division of Cardiology (D.S.), Department of Medicine, Columbia University Medical Center, New York, New York; Department of Psychology (W.C), St. John’s University, New York, New York; Section of Cardiovascular Medicine (M.M.B.), Yale University School of Medicine, New Haven, Connecticut.

Address correspondence and reprint requests to Daichi Shimbo, Center for Behavioral Cardiovascular Health, Division of General Medicine, Columbia University Medical Center, 622 West 168th Street, PH 9-949, New York, NY 10032. E-mail: ds2231{at}columbia.edu

Objective: To examine the association between hostility and platelet reactivity in individuals without a prior history of cardiovascular disease (CVD) events. Hostility is associated with incident CVD events, independent of traditional risk factors. Increased platelet reactivity and thrombus formation over a disrupted coronary plaque are fundamental for CVD event onset.

Methods: Hypertensive patients (n = 42) without concomitant CVD event history completed the 50-item Cook-Medley Hostility Scale, and a subset score of 27 items (Barefoot Ho) was derived. We examined the relationship between Barefoot Ho scores and platelet aggregation. We also examined individual components of Barefoot Ho (aggressive responding, cynicism, and hostile affect) and their associations with platelet aggregation. Platelet reactivity, induced by adenosine diphosphate (ADP), was assessed by standard light transmission aggregometry, the current gold standard method of platelet aggregation assessment.

Results: Barefoot Ho scores were related significantly to increased rate of platelet aggregation in response to ADP. Of the three Barefoot Ho components, only aggressive responding was associated independently with increased platelet aggregation rate. The strength of these relationships did not diminish after adjusting for several standard CVD risk factors.

Conclusions: These data demonstrate that hostility, particularly the aggressive responding subtype, is associated with platelet reactivity—a key pathophysiological pathway in the onset of CVD events.

Key Words: platelets • hostility • coronary heart disease

Abbreviations: ADP = adenosine diphosphate; Barefoot Ho = 27-item Barefoot Hostility Scale; BTG = B-thromboglobulin; CHD = coronary heart disease; CVD = cardiovascular disease; LTA = light transmission aggregometry; PPP = platelet-poor plasma; SI = Structured Interview.

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