When we think about risk factors for heart disease, we typically
talk about smoking, high blood pressure, diabetes, obesity and
family history as being the most significant . But did you know
that your personality and behavioral pattern can also be a
predictor of coronary heart disease?
Research has taught us that aspects of hostility such as the
expression of anger in interpersonal contexts were particularly
predictive of heart disease. There are models of factors of
personality. Agreeable individuals tend to be trusting,
straightforward and show concern for others. By contrast, those
who are less agreeable and score high on antagonism are more
likely to be cynical, manipulative, self-centered, arrogant and
are very quick to express their anger. The antagonism traits
have been linked to stroke, fatal and non fatal coronary events,
silent heart attacks and an increased likelihood of having a
procedure to repair coronary arteries.
Ultrsound can measure the thickness of arterial walls and the
thickness of the carotid arterial wall- called intima-media
thickness or IMT, is a marker of heart disease. While the
thickness of our carotid artery increases with age, the wall is
also very sensitive to high blood pressure and will increase
with hypertension. IMT is an independent marker and an
objective marker of stroke and future heart attack (MI).
In this week’s journal Hypertension is a study looking at how
antagonism as a personality trait can impact on the IMT. More
than 5,500 Italian individuals were studied to assess the
impact of personality on IMT.
Personality traits studied were:
They ranked how they saw their personality on a scale from 1-5,
strongly disagree to strongly agree. Ultrasound was used to
study the IMT at baseline and follow up 3 years later. Factors
that were controlled for included age, sex, education, waist
circumference, blood pressure, cholesterol and triglycerides,
insulin and glucose, smoking and medications used.
Those that were arrogant, antagonistic and manipulative were
found to have greater IMT at baseline. 3 years later, antagonism
was associated with the progression of IMT as well. Those who
scored high on antagonism ( low agreeableness), manipulative (
low straightforward) and quick to express their anger (low on
compliance) had greater thickening. Older participants who
were disagreeable had greater thickening than younger
participants. These kinds of findings were particularly dramatic
in women. Men generally have thicker arteries than women do,
but women who were antagonistic had IMT values more similar
Agreeableness had a 16 per cent reduction in risk but those in
the lowest 10 per cent of this trait, had a 40 per cent increase
in the risk of an elevated IMT.
So, what possibly can account for these findings? There have
been a few theories. Those who are antagonistic are also found
to be more likely to have metabolic syndrome, be smokers or
not exercise, but in this study, the findings were there after all
this was controlled for. In part it might be because these
individuals are more isolated as their personalities undermine
relationships. Antagonism has been linked to our stress
hormone cortisol and this can impact IMT.
Regardless of why, we can add personality to risk factors for
heart disease! Anger management may be a good way to
reduce cardiovascular risk!!