Do anger and aggression affect carotid atherosclerosis?

BACKGROUND AND PURPOSE Although a number of metabolic and psychosocial factors have been identified as coronary risk factors, no studies have evaluated the relation between personality and cerebrovascular disease. The purpose of the present study was to elucidate the relation between the characteristics of anger or aggression and the severity of carotid atherosclerosis on the basis of the findings of B-mode ultrasonography. METHODS The Cornell Medical Index was used to measure anger in 34 patients with signs of atherosclerosis or at least one of four recognized risk factors for atherosclerosis (hypertension, hypercholesterolemia, diabetes mellitus, and cigarette smoking). The Rosenzweig Picture Frustration Study and Yatabe-Guilford Personality Test were used to evaluate aggression. High-resolution B-mode ultrasonography was performed, and the severity of carotid atherosclerosis was determined by plaque score. The occurrence of risk factors for carotid atherosclerosis was compared among the patients. RESULTS The correlation of plaque score with one item that endorses anger was r = .65 (P < .01) and with "extrapersistive" in aggression was r = .50 (P < .01). Multivariate analysis identified significant correlations between plaque score and age, hypercholesterolemia, and anger. CONCLUSIONS Our results suggest that anger and, perhaps, aggression may be risk factors for cerebrovascular disease.