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September 15, 2020
1 min read
Hostility can increase the risk of mortality in patients with ACS, although it may not affect the risk of recurrent ACS, the researchers found.
“Hostility is a personality trait that includes being sarcastic, cynical, resentful, impatient or irritable” Tracey K. Vitori, PhD, RN, ACNP, Assistant Professor at the University of Tennessee College of Nursing in Knoxville, it said in a press release. “It is not just a one-time occurrence, but it characterizes how a person interacts with people. We know that taking control of lifestyle habits improves the outlook for heart attack patients, and our study suggests that improving hostile behaviors could also be a positive step. “
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In a secondary analysis of the PROMOTION trial published in the European Journal of Cardiovascular Nursing, the researchers analyzed data from 2,321 patients (mean age, 67 years; 68% men; 73% married) with ACS. The information was collected through review of medical records, structured interviews, and pencil and paper instruments, one of which was the Multiple Affect Adjectives Checklist for Measuring Hostility. Through this, the patients selected adjectives that described their feelings during the past week. Higher scores suggested greater hostility. The threshold for a patient with a high level of hostility was a score of 7.
A 24-month follow-up was performed for ACS recurrence and all-cause mortality.
Of the study patients, 57% were considered hostile (mean score, 7.56). The mean score in patients with hostility was 10.3 compared to 4 in those without hostility (P <0.001).
Recurrent ACS occurred in 8.3% of the patients. Hostility was not an independent predictor of ACS recurrence (P = .792) despite showing significance in the Cox regression model (P <0.001).
During the follow-up, 1.6% of the patients died. The researchers found that hostility was an independent predictor of all-cause mortality (P <.039). Each unit of increase in hostility score was associated with a 52% higher chance of mortality.
“Identifying and treating hostility should be a priority, along with optimizing physical and health behaviors to reduce cardiovascular risk,” Vitori and colleagues wrote. “The prevention and treatment of hostility to decrease mortality seems an important treatment goal, particularly from a multidisciplinary approach.”
