Have a Heart, Not an Attack

If there were any doubt that being a mean, in-your-face kind of person is generally just unhealthy, a group of researchers for the U.S. National Institute on Aging has just set the record straight. According to a new report in Hypertension: Journal of the American Heart Association, antagonistic people, particularly those who are competitive and aggressive, may well be increasing their risk of heart attack or stroke just by being themselves. This is not good news for Philadelphia Eagles' fans.

In what almost certainly had to be sometimes unpleasant work, the NIA scientists studied 5,614 Italians in four villages in Sardinia and found that those who scored high for antagonistic traits on a standard personality test had greater thickening of the neck (carotid) arteries compared to people who were more agreeable. The study points out that thickness of neck artery walls is a risk factor for heart attack and stroke which, in turn, is not necessarily good news for Mickey Rourke or Donald Trump.

After three years of the study, researchers found that those who scored higher on antagonism or low agreeableness -- especially those who were manipulative and quick to express anger -- continued to have thickening of their artery walls. These traits also predicted greater progression of arterial thickening.

The study notes that those who scored in the bottom 10 percent of agreeableness and were the most antagonistic had about a 40-percent increased risk for elevated intima-media thickness, a measure of arterial wall thickness.

"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," said Angelina Sutin, Ph.D., lead author of the study and a postdoctoral fellow with NIA, a component in Baltimore of the National Institutes of Health, which funded the study. "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."

Called the SardiNIA Study of Aging, the research included participants aged 14 to 94 years, 58 percent of whom were female. All participants answered a standard personality questionnaire, which included six facets of agreeableness: trust, straightforwardness, altruism, compliance, modesty, and tender-mindedness.

Researchers used ultrasound to determine the intima-media thickness of the carotid arteries in the neck at five points. Participants also were screened for high blood pressure, cholesterol levels, triglycerides, fasting glucose, and diabetes.

Not surprisingly, the male participants had, in general, more thickening of the artery walls. But Sutin does note that if women were antagonistic, their risk quickly caught up with the men. "Women who scored high on antagonism-related traits tended to close the gap, developing arterial thickness similar to antagonistic men," she said. "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." Sutin added that although thickening of the artery walls is a sign of age, young people with antagonistic traits already had the artery-wall thickening issues.

The study further showed that while lifestyle factors contribute to overall health risks, the antagonistic association persisted after controlling for risk factors such as smoking. The NIA scientists concluded that physicians may want to examine antagonism and other facets of personality traits when considering risk factors such as smoking, weight, cholesterol, levels, and diabetes -- and that the results of this study could also help determine who might benefit from targeted interventions such as providing coping mechanisms and anger management.

"People may learn to control their anger and learn ways to express anger in more socially acceptable ways," Sutin said, adding that the group's findings may apply to others in the world, whether they live in smaller towns or cosmopolitan areas. "This may not be unique to Italians," she said.

I'm going to go out on not much of a limb here and say I bet further studies show NIA's findings to be universal -- that not only are they not unique to Italians in Sardinia but neither are they unique to any population anywhere, including Philadelphia.

The curious part of this study, to me, is the finding that the antagonistic group's undoing resided in the carotid artery thickening. I'm guessing that whoever first thought to look there had encountered more than his or her share of people who were generally just pains in the neck, which is pretty ironic, if you think about it.

Posted by Ronnie Rittenberry on Aug 23, 2010