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Personality type and the ability to control anger may have an effect on heart health and one's risk for stroke, according to a new study published in Hypertension: Journal of the American Heart Association.

Researchers from the National Institute on Aging (NIA) in Baltimore, a division of the National Institutes of Health, found that people who are angry and aggressive showed a greater thickness of the carotid arteries in the neck, a key risk factor for heart attack or stroke, compared with people who were more easygoing.

Moreover, people considered the least agreeable and the most antagonistic had a 40% increased risk for arterial wall thickening. This is similar to the risk imparted by having metabolic syndrome, a known potent contributor to heart disease. The findings suggest that physicians should consider personality traits when screening patients for cardiovascular disease, the leading cause of death in the United States. According to the American Heart Association, there are about 1.2 million heart attacks and 800,000 strokes every year. Cardiovascular disease accounts for about one-third of all deaths.

The researchers write that "when the Type A behavioral pattern was dissected into its constituent parts, hostility emerged as the dominant predictor of coronary artery disease." Their latest findings uphold the connection between aggressive behavior and heart health.

"People who tend to be competitive and more willing to fight for their own self-interest have thicker arterial walls, which is a risk factor for cardiovascular disease," says study author Angelina Sutin, PhD, a postdoctoral fellow at the NIA. "Agreeable people tend to be trusting, straightforward, and show concern for others, while people who score high on antagonism tend to be distrustful, skeptical, and at the extreme cynical, manipulative, self-centered, arrogant, and quick to express anger."

NIA researchers studied 5,614 village residents living in Sardinia, Italy; 58% were female, and the mean age was about 42. Participants either self-reported their behaviors through a questionnaire or chose to have their questionnaires filled out by a trained local psychologist.

Ultrasound imaging was used to measure carotid artery and arterial wall thickness at five points, and the participants were screened for other major cardiovascular disease risk factors, including smoking, high blood pressure, cholesterol triglyceride levels, fasting blood sugar levels, and diabetes.

The study results showed that even young people who were antagonistic displayed thickening of the artery wall above and beyond what would be expected based on traditional risk factors alone. Overall, men had more thickening of the artery walls compared to women. But "women who scored high on antagonism-related traits tended to close the gap, developing arterial thickness similar to antagonistic men," Sutin says. "Whereas women with agreeable traits had much thinner arterial walls than men with agreeable traits, antagonism had a much stronger association with arterial thickness in women."

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