Observed Hostility Better Predictor of Heart Disease than Patient Report

Contact: Amanda Jekowsky, ajekowsk@acc.org, 202-375-6645

Hostility identified by an interviewer, called “observed hostility,” appears to be a better predictor of ischemic heart disease than patient-reported hostility, and the presence of any hostility is more important than the severity, according to a study published in the Journal of the American College of Cardiology (JACC). The study, appearing in the September 13, 2011 issue, found any level of observed hostility was associated with a two-fold increased risk in heart disease, independent of other psychosocial and cardiovascular risk factors.
The authors noted that patient-reported scales require self-awareness of hostility and are more susceptible to reporting bias while interviewer-based measures allow for the assessment of interpersonal cues.
“Previous studies have found that there is a link between patient-reported hostility and increased risk of heart disease,” said Karina Davidson, PhD, a clinical psychologist from Columbia University College of Physicians and Surgeons, and one of the study’s researchers. The study noted other studies have failed to identify such a relationship.
“We wanted to take a look at whether or not observed hostility is associated with increased heart disease risk. We also were curious about whether or not heart disease risk increases as patients show more hostility.” 
While the researchers anticipated a gradient relationship between observed hostility and incidence of heart disease, the study found severity had little impact on future development of heart disease.


The American College of Cardiology is transforming cardiovascular care and improving heart health through continuous quality improvement, patient-centered care, payment innovation and professionalism. The College is a 39,000-member nonprofit medical society comprised of physicians, surgeons, nurses, physician assistants, pharmacists and practice managers, and bestows credentials upon cardiovascular specialists who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at http://www.cardiosource.org/ACC.

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