As in men, a hostile temperament may worsen the outlook for women with signs and symptoms of Heart disease, a new study suggests.

Among 506 women doctors evaluated for suspected Heart disease, those with high scores on a standard measure of hostility were at greater risk of suffering a Heart Attack, stroke or other complication over the next 3 to 6 years.

The findings are in line with past research that has tied chronic hostility and anger to both a higher risk of Heart disease and poorer outcomes from the disease. But most of those studies have included only men.

The current study, published in the journal Psychosomatic Medicine, used a standard questionnaire to gauge certain measures of hostility, such as a person’s level of cynicism, and tendency to be rude, insulting or physically aggressive.

Overall, women with higher scores on these measures had more “events,” including Heart Attacks, Strokes, and hospitalization for Chest pain , the study’s lead author, Marian B. Olson told.

Women with hostile temperaments also tended to have lower “good” cholesterol levels, higher blood pressure and larger waistlines - all risk factors for heart disease. Even with these additional risk factors considered, however, women with higher hostility scores were 50 percent more likely than their more mellow peers to die or suffer a complication over the next few years.

The study included 506 women who underwent tests for blockages in the heart arteries after having symptoms such as chest pain. About 6 months later, they completed a standard questionnaire on hostility, then were followed for the next 3 to 6 years.

Hostility may affect Heart disease outcomes through both direct, biological means and through behavior, according to Olson, who was an epidemiologist at the University of Pittsburgh in Pennsylvania at the time of the study.

Anger and hostility have physiological effects - such as raising blood pressure and the release of so-called stress hormones - that can be hard on the cardiovascular system over time. Some studies have tied hostility to increased activity in platelets - blood cells that help form clots - and thickening in the blood vessel walls, both of which can raise the risk of Heart Attack and Stroke.

But there’s also the matter of unhealthy behavior. In the current study, Olson pointed out, women with higher hostility scores had higher rates of smoking and abdominal Obesity, among other risk factors.

“So they are engaging in behavior that increases their risk of events,” she noted.

Though evidence is piling up that hostility is hard on the heart, research has not yet shown whether addressing the personality trait - through anger management therapy, for example - improves cardiovascular health.

SOURCE: Psychosomatic Medicine, July/August 2005.