Abstract P208: Anger During Young Adulthood Increases the Risk of Developing Coronary Heart Disease

Abstract

Background: Some cohort studies have found that anger in adults aged 45+ is associated with incident coronary heart disease (CHD). However, this relationship has not been tested rigorously in young adults. We took advantage of longitudinal measures collected by the Bogalusa Heart Study to examine this association prospectively in young adults. Methods: From 1985-1986, 768 young adults from the Bogalusa Heart Study completed the State Trait Anger Expression Inventory (STAXI) and were followed for cardiovascular risk factors. STAXI score is summed from a ten-point test with four response options (1=”never angry”; 2=”sometimes angry”; 3=”often angry”; 4=”almost always angry”). Multivariable linear regression, adjusted for race, BMI, pulse, blood glucose, and alcohol use, was used to test the association between anger and Framingham risk score as a global indicator of CHD risk. Participants were followed through 2010 and a general estimating equations model was used to assess the association between young adult anger (modeled using a restricted cubic spline function) and longitudinal development of CHD risk. Results: Our study population was (63.3%) female and (23.2%) black. At baseline, age ranged from 17-27 with a mean (SD) of 22.7 (2.4), and mean STAXI score was 18.6 (5.2). In cross-sectional analyses, STAXI score was not associated with CHD risk at baseline (p=0.20). However, after a median follow-up of 18 years, young adult anger was strongly associated (p=.006) with risk of CHD, with “always angry” subjects having a greater Framingham risk score at follow-up compared to “never angry” subjects (RR=1.71; 95%CI, 1.08 to 2.71), corresponding to a four-fold increase in 10-year risk of incident CHD (4% vs 1%, respectively). Conclusions: While it is currently established that anger in middle or late adulthood increases CHD risk, our analysis shows that, in fact, this relationship may be etiologically present much earlier in adulthood and among populations with a low overall CHD risk.