slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
The ARIC Study PowerPoint Presentation
Download Presentation
The ARIC Study

Loading in 2 Seconds...

play fullscreen
1 / 30

The ARIC Study - PowerPoint PPT Presentation


  • 509 Views
  • Uploaded on

Anger and Coronary Heart Disease: Epidemiologic Evidence from the Atherosclerosis Risk in Communities (ARIC) Study Janice E. Williams, PhD, MPH Centers for Disease Control and Prevention. The ARIC Study. Two research arms Cohort Community morbidity/mortality surveillance. Types of Anger.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'The ARIC Study' - Jims


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Anger and Coronary Heart Disease: Epidemiologic Evidence fromthe Atherosclerosis Risk in Communities (ARIC) StudyJanice E. Williams, PhD, MPHCenters for Disease Control and Prevention

the aric study
The ARIC Study
  • Two research arms
    • Cohort
    • Community morbidity/mortality surveillance
types of anger
Types of Anger
  • Anger experience
    • Transitory state (state anger)
    • Stable and general predisposition to experience anger (trait anger)
types of anger1
Types of Anger
  • Anger expression
    • Anger in
    • Anger out
    • Anger control
trait anger
Trait Anger
  • Subtypes
    • Temperament
    • Reaction
anger and chd studies
Anger and CHD Studies
  • Have employed the following study designs to provide evidence of an association
    • cross-sectional
    • prospective
    • laboratory/clinical
anger and chd aric study
Anger and CHD: ARIC Study
  • Relationship of overall trait anger and subtypes to
    • CHD (revascularization procedures, silent MI, acute MI/fatal CHD)
methods
Methods
  • 13,000 black and white men and women, aged 48 - 67, free of clinically manifest CHD
  • Completed Spielberger Trait Anger Scale
methods1
Methods
  • Followed from 1990 - 1995 for the occurrence of CHD (revascularization procedures, silent MI, acute MI/fatal CHD)
spielberger trait anger scale
Spielberger Trait Anger Scale
  • I am quick tempered.
  • I have a fiery temper.
  • I am a hotheaded person.
  • I get angry when I am slowed down by others’ mistakes.
spielberger trait anger scale continued
Spielberger Trait Anger Scale (continued)
  • I feel annoyed when I am not given recognition for doing good work.
  • I fly off the handle.
  • When I get angry, I say nasty things.
spielberger trait anger scale continued1
Spielberger Trait Anger Scale (continued)
  • It makes me furious when I am criticized in front of others.
  • When I get frustrated, I feel like hitting someone.
spielberger trait anger scale continued2
Spielberger Trait Anger Scale (continued)
  • I feel infuriated when I do a good job and get a poor evaluation.
trait anger temperament subscale
Trait Anger-Temperament Subscale
  • I am quick tempered.
  • I have a fiery temper.
  • I am a hotheaded person.
  • I fly off the handle.
trait anger reaction subscale
Trait Anger - Reaction Subscale
  • I get angry when I am slowed down by others’ mistakes.
  • I feel annoyed when I am not given recognition for doing good work.
trait anger reaction subscale continued
Trait Anger - Reaction Subscale (continued)
  • It makes me furious when I am criticized in front of others.
  • I feel infuriated when I do a good job and get a poor evaluation.
spielberger trait anger scale1
Spielberger Trait Anger Scale
  • Coding
    • 1) Almost never
    • 2) Sometimes
    • 3) Often
    • 4) Almost always
statistical analyses
Statistical Analyses
  • Means and percentages to describe the population by CHD risk factors.
  • -2 log likelihood tests to assess interactions of covariates with anger.
statistical analyses continued
Statistical Analyses (continued)
  • Proportional hazards regression models to assess anger-CHD association.
  • Kaplan-Meier product limit method to assess probabilities of CHD event-free survival.
covariates
Covariates
  • Drinking
  • Smoking
  • Diabetes
  • Age
  • Race
  • Gender
  • Education
  • Waist-to-hip ratio
  • LDL-and HDL-cholesterol
results
Results
  • Compared to their low-anger counterparts, persons high in trait anger were more likely to:
    • be smokers and drinkers
    • be heavier
    • have less formal education
slide22
Multivariate-adjusted hazard ratios (95% C.I.) for the association between overall trait anger and CHD risk

_

_

_

_

_

_

_

_

slide23
Multivariate-adjusted hazard ratios (95% C.I.) for the association between trait anger-temperament and CHD risk

_

_

_

_

_

_

_

_

slide24
Multivariate-adjusted hazard ratios (95% C.I.) for the association between trait anger-reaction and CHD risk

_

_

_

_

summary
Summary
  • Overall trait anger was positively associated with risk of both combined CHD and of “hard” events (acute MI/fatal CHD) among normotensive individuals.
summary1
Summary
  • Similarly, trait anger-temperament was positively associated with combined CHD and with “hard” events (acute MI/fatal CHD) among normotensive individuals.
s ummary
Summary
  • No statistically significant association was observed between trait anger-reaction and CHD.
conclusions
Conclusions
  • A fiery temper predisposes middle-aged normotensive persons to a greater risk of CHD than anger aroused in reaction to frustration, criticism, or unfair treatment.
the mechanism
The Mechanism
  • High-anger persons, compared to their low-anger counterparts, may be more likely to engage in unhealthy behaviors that place them at risk for CHD.
the mechanism1
The Mechanism
  • Direct pathophysiological effects via heightened sympathetic arousal and neuroendocrine activation.