Costly hospital readmissions among chronic heart failure (CHF) patients are expected to increase dramatically with the ageing population. This study investigated the prognostic ability of depression, anger and anxiety, prospectively, and after adjusting for illness severity, on the number of readmissions to hospital and the total length of stay over one year. Participants comprised 175 inpatients with CHF. Depression, anger, anxiety, and illness severity were measured at baseline. One year later, the number of readmissions and length of stay for each patient were obtained from medical records. Depression and anger play a detrimental role in the health profile of CHF patients.

Anger and depression predict hospital use among chronic heart failure patients

Background: Psychosocial stress and anger trigger cardiovascular events, but their relationship to heart failure (HF) exacerbations is unclear. We investigated perceived stress and anger associatio...

Associations of perceived stress and state anger with symptom burden and functional status in patients with heart failure.

Hostility is associated with increased risk for cardiovascular disease. Heightened cardiovascular reactivity to psychological stress has been proposed as a potential mechanism. Recent work has emphasized a need to measure cardiovascular reactivity across multiple stress exposures to assess potential habituation over time. The aims of the current study were (a) to examine the relationship between each of the three main components of hostility (i.e., emotional, cognitive, and behavioral) and cardiovascular reactivity at two separate stress testing visits and (b) to examine the relationship between hostility components and cardiovascular reactivity habituation. This study utilized previously collected data from the Pittsburgh Cold Study 3. One hundred and ninety-six participants (Mean (SD)[range] age = 29.9 (10.8)[18-55] years, 42.9% female, 67.3% Caucasian) completed 2 separate, identical laboratory sessions, consisting of a 20-min baseline and 15-min stress (Trier Social Stress Test). Heart rate and systolic/diastolic blood pressure were recorded throughout. Reactivity was calculated separately for heart rate, systolic, and diastolic blood pressure (stress-baseline). Participants also completed a modified version of the Cook-Medley Hostility Scale. Results indicated that greater cognitive hostility (i.e., cynicism) was associated with blunted cardiovascular reactivity at Visit 1 and less cardiovascular reactivity habituation between visits, even when controlling for confounding variables. No significant relationships to cardiovascular reactivity or habituation were found for emotional (i.e., hostile affect) or behavioral (i.e., aggressive responding) components. Outcomes for total hostility did not survive adjustment for confounders. These results identify a potential pathway through which hostility, particularly cynicism, contributes to disease risk.

Cynical hostility relates to a lack of habituation of the cardiovascular response to repeated acute stress.

Discrimination Increases the Association Between Parental and Adolescent Allostatic Load in Chinese Rural-to-Urban Migrants.

Cynical hostility (or cynicism) is often considered as a major factor leading to bad health outcomes. The present research proposes that poor health might represent both a consequence and a source ...

https://onlinelibrary.wiley.com/doi/pdf/10.1002/per.2183

Broken Bodies, Broken Spirits: How Poor Health Contributes to A Cynical Worldview:

: Heart failure is a major health concern in the U.S., with billions of dollars spent annually on health care. The high number of re-hospitalizations significantly contributes to these rising health care costs. Traits of anger and hostility are psychological variables that have been associated with coronary heart disease morbidity and mortality. The present hypothesized that anger and hostility would show predictive utility for heart failure-related and all-cause hospitalizations in patients diagnosed with heart failure. Furthermore, it was hypothesized that depressive symptoms and cytokines will mediate the relationship between anger/hostility and hospitalizations. 150 heart failure patients were recruited from the Heart Failure Clinic at the University of Maryland Hospital in Baltimore, MD, at baseline participants were administered the ST AXI, the Cook-Medley Hostility Scale, the Beck Depression Inventory, and cytokines levels were collected. Hospitalization data was then collected for every participant for up to 36-months. Results indicated that only the Cook-Medley Hostility Scale significantly predicted all-cause hospitalizations and not heart failure related hospitalizations. Furthermore, analyses did not support the cytokine hypothesis or a mediating role of depression. However, results revealed that perceived heart failure symptoms were a significant mediator in the relationship between hostility and all-cause hospitalizations. These results indicate that hostility may predict hospitalizations, not by impacting heart failure directly, but instead by working to shape negative health behaviors that influence health in a global manner.

Felicia Keith

Papers

Anger, Hostility, and Re-hospitalizations in Patients with Heart Failure