Relation between hostility and coronary heart disease

BMJ 1999;319:917 ( 2 October )

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Relation between hostility and coronary heart disease

Evidence does not support link

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Evidence does not support link

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EDITOR $---$ The summary points of Hemingway and Marmot's review of psychosocial risk factors for coronary heart disease may bemisleading.¹ The first of these states that "prospective cohortstudies show a possible aetiological role for type A/hostility."However, of the four prospective studies of hostility, only twoshow any significant association between hostility and coronaryheart disease (one for women only). Six of the nine aetiologicalstudies of type A behaviour also show no association with coronaryheart disease. The other three studies give no information oncompleteness of follow up or whether outcomes such as angina wereassessed in a blinded manner. One of these studies had minimaladjustment for confounding. No study showed any prognostic rolefor type A behaviour or hostility. Taken together, these studiesdo not represent robust evidence that these psychological variableshave an important role in the development or prognosis of coronaryheart . . . [Full text of this article]

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Evidence based cardiology: Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies: Harry Hemingway and Michael Marmot
BMJ 1999 318: 1460-1467. [Extract] [Full Text] [PDF]

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