The Relationship between Expressive/Suppressive Hostility Behavior and Cardiac Autonomic Activations in Patients with Coronary Artery Disease

Background: Hostility is an important psychosocial risk factor in coronary artery disease (CAD). Expressive and suppressive hostility behaviors are related to cardiovascular response in healthy adults. However, the relationships of these behavioral dimensions to cardiac autonomic activations in CAD remain unclear. Method: This study involved 76 patients with CAD to whom a hostility inventory was administered, who were instructed to recall a neutral event and an anger-related event. Heart rate and blood pressure were obtained for each patient as the indices of cardiovascular response; heart rate variability was transformed from electrocardiograph and as the indices of cardiac autonomic activation. Results: The results showed that CAD patients with expressive hostility behavior experienced higher cardiovascular autonomic activations during the neutral and anger recall tasks, and lower parasympathetic activations during the recovery after an anger episode. On the other hand, CAD patients with suppressive hostility behavior experienced both sympathetic and parasympathetic activations during the baseline and recovery stages, aswell as simultaneously activated higher parasympathetic response. Conclusions: The results of this study suggested that it is appropriate to extend the cardiac autonomic activation model for expressive and suppressive hostility behaviors in patients with CAD.