Anger, Hostility, and Re-hospitalizations in Patients with Heart Failure

Abstract

Abstract : Heart failure is a major health concern in the U.S., with billions of dollars spent annually on health care. The high number of re-hospitalizations significantly contributes to these rising health care costs. Traits of anger and hostility are psychological variables that have been associated with coronary heart disease morbidity and mortality. The present hypothesized that anger and hostility would show predictive utility for heart failure-related and all-cause hospitalizations in patients diagnosed with heart failure. Furthermore, it was hypothesized that depressive symptoms and cytokines will mediate the relationship between anger/hostility and hospitalizations. 150 heart failure patients were recruited from the Heart Failure Clinic at the University of Maryland Hospital in Baltimore, MD, at baseline participants were administered the ST AXI, the Cook-Medley Hostility Scale, the Beck Depression Inventory, and cytokines levels were collected. Hospitalization data was then collected for every participant for up to 36-months. Results indicated that only the Cook-Medley Hostility Scale significantly predicted all-cause hospitalizations and not heart failure related hospitalizations. Furthermore, analyses did not support the cytokine hypothesis or a mediating role of depression. However, results revealed that perceived heart failure symptoms were a significant mediator in the relationship between hostility and all-cause hospitalizations. These results indicate that hostility may predict hospitalizations, not by impacting heart failure directly, but instead by working to shape negative health behaviors that influence health in a global manner.