There is evidence that anger and hostility are positively associated with the metabolic syndrome. In turn, the metabolic syndrome mediates the association between anger and hostility and adverse cardiac events. Very little is known about these associations in African-American populations. We assessed the hypothesis that anger and hostility are positively associated with the metabolic syndrome in an African-American cohort. Participants were 2,732 African-American men and women, ages 45 – 95, who were enrolled in the Jackson Heart Study at baseline. Anger was measured using the Spielberger State-Trait Anger Inventory, and hostility was measured using the Cook-Medley Hostility Scale. The metabolic syndrome was defined by the National Cholesterol Education Program, Adult Treatment Panel III criteria. Overall anger, components anger-in and anger-out, and hostility scores were entered into separate logistic regression models as continuous variables. In models adjusted for age, sex, educational level, and physical activity, higher levels of overall anger (β = 0.024, p = 0.006), anger-in (β = 0.028, p = 0.04), anger-out (β = 0.037, p = 0.04), and hostility (β = 0.021, p = 0.04) were associated with an increased prevalence of the metabolic syndrome. The correlation between anger and hostility was statistically significant but not strong (r = 0.38, p <0.0001). In men, 5 of the 16 individual anger items were significantly associated with the metabolic syndrome. The strongest was “I lose my temper” (β = 0.395, p = 0.003) and “I tend to harbor grudges” (β = 0.314, p = 0.008). In women, only 1 anger item, “I make sarcastic remarks” (β = 0.189, p = 0.04) was associated with the metabolic syndrome. In conclusion, higher levels of overall anger, anger-in, anger-out, and hostility were associated with an increased prevalence of the metabolic syndrome in middle- and older-aged African-American men and women. In men, an angry temperament and a tendency to hold grudges were particularly strong correlates of the metabolic syndrome. Increased understanding of the negative emotions anger and hostility among African-Americans may provide greater insights into cardiovascular disease risk in their population.
Homeostasis model assessment of insulin resistance (HOMA-IR) and metabolic syndrome at baseline of a multicentric Brazilian cohort: ELSA-Brasil study
