Study: Beware the bad attitude, as it may develop into MI, stroke

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Antagonistic people who exhibit competitive and aggressive behavior may be at an increased risk to develop heart attack or stroke, according to a study published online Aug. 16 in Hypertension: Journal of the American Heart Association.

Angelina Sutin, PhD, of the U.S. National Institute on Aging (NIA), a component of the National Institutes of Health (NIH) in Baltimore, Md., conducted the SardiNIA Study of Aging, which enrolled 5,614 Italians from four villages in the Sardinia region of Italy to evaluate personality traits and their association with cardiovascular risk factors.

Patients had an average age of 42 and 58 percent were female.

“People who tend to be competitive and more willing to fight for their own self interests have thicker arterial walls, which is a risk factor for cardiovascular disease," said Sutin. "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."

Researchers administered personality questionnaires to patients asking six facets of agreeableness—trust, straightforwardness, altruisms, compliance, modesty and tender mindedness—and performed ultrasounds to determine the intima-media thickness of the carotid arteries in patients'  necks.

Results showed that those who scored higher on antagonism or low agreeableness traits had a heightened thickening of the artery walls, which predicted greater progression of arterial thickening.

The researchers also found that patients who scored at the bottom 10 percent of agreeableness and who were most antagonistic had a 40 percent increased risk for heightened intima-media thickness.

While men had more thickening of the artery walls, researchers found that antagonistic women’s risk caught up with men’s. "Women who scored high on antagonism related traits tended to close the gap, developing arterial thickness similar to antagonistic men. 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,” said Sutin.

Additionally, researchers screened patients for other CV risk factors including high blood pressure, cholesterol levels, triglycerides, fasting glucose and diabetes.

While normally a thickening of the artery walls is a sign of older age, the researchers found that younger patients who exhibited antagonistic traits also saw thickening of the artery walls.

“Physicians may want to examine antagonism and other facets of personality traits when considering risk factors such as smoking, weight, cholesterol levels and diabetes,” the authors wrote. “The results of this study could also help determine who might benefit from targeted interventions such as providing coping mechanisms and anger management.”

The authors concluded that the effect on the artery walls was similar to having metabolic syndrome—a risk factor for CV disease.

The study was funded by the NIA's Intramural Research Program.