Abstract :
Despite the well-known impact of baseline hostility and anger on
subsequent cardiovascular mortality, few studies have tested whether
predictive role of hostility and anger on mortality varies as a function
of race and gender. Current study explored role of race and gender in
modifying the effects of baseline hostility and anger on cardiovascular
mortality in a nationally representative sample in U.S. We used data
from the Americans’ changing lives study, a nationally representative
longitudinal cohort of U.S. adults. The study followed 1,593 Blacks or
Whites for 10 years from 2001 to 2011. Independent variables were
baseline hostility and anger (anger-in, and anger-out), measured at
2001, using 4 item Cook-Medley cynical hostility scale and Spielberger
Anger Expression scales, respectively. Dependent variable was time to
death due to cardiovascular disease since 2001. Covariates were baseline
socio-demographics (age and education), behaviors (smoking and
drinking), and health (number of chronic medical conditions, self-rated
health, and depressive symptoms) measured at 2001. We used Cox
proportional hazard models in the pooled sample and specific to race, in
the absence and presence of health variables. In the pooled sample,
baseline hostility and anger-out predicted cardiovascular mortality in
the next 10 years. We found significant interactions between race and
baseline hostility and anger-in on cardiovascular mortality, suggesting
that these associations are stronger for Whites than Blacks. Race did
not interact with baseline anger-out on cardiovascular mortality. Gender
also did not have any interactions with baseline hostility, anger-in, or
anger-out on cardiovascular mortality. Hostility and anger-in better
predict cardiovascular mortality among Blacks than Whites in the United
States. Black - White difference in the associations of hostility and
anger with cardiovascular mortality suggest these factors may have some
role in shaping health disparities across racial groups.
