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DURHAM, N.C. -- Frequent bouts of depression, anxiety,
hostility and anger are known to increase a person's risk for
developing coronary heart disease, but a combination of these
"negative" personality traits may put people at especially
serious risk, according to a study by researchers at Duke
University Medical Center.

"The risk of developing coronary heart disease due to a
combination of negative personality traits in people has never
before been explored," said the study's senior investigator,
Edward C. Suarez, Ph.D., an associate professor of psychiatry.
"Although each of the negative traits significantly predicted
heart disease, having the combination of these traits was the
most powerful predictor of heart disease."

Similar patterns have been reported with three traditional
risk factors of heart disease -- high blood pressure, elevated
cholesterol levels and excessive weight -- where each factor
independently increases risk but their presence together
predicts a greater risk of future heart disease, Suarez
said.

The findings appear in an early online edition of the
November/December 2006 issue of the journal Psychosomatic
Medicine.

The research was funded by the National Institutes of Health.

The team analyzed data on 2,105 military veterans who served
in the Vietnam War and took part in the U.S. Air Force Health
Study, in which researchers tracked the health of participants
for 20 years. None of the men enrolled had heart disease when
the study began.

At the start of the study, participants took a personality
inventory test, called the Minnesota Multiphasic Personality
Inventory, in which they stated whether or not they thought of
themselves as possessing various personality and behavioral
traits. At six intervals during the study, the participants
underwent physical examinations that recorded health
information, including blood pressure rates, cholesterol levels
and body mass index, that can indicate whether or not someone
is at risk for developing coronary heart disease.

Suarez said his team looked for a possible correlation
between each individual negative personality trait and
development of coronary heart disease, and then for a possible
correlation between a combination of the negative personality
traits and the development of coronary heart disease.

The researchers found that each negative personality trait,
by itself, was significantly associated with increased risk for
heart disease. However, when they analyzed all of the traits in
combination, they found statistical evidence that the
clustering of traits was the best predictor of a person's risk
for heart disease, Suarez said.

According to the researchers, the findings may prompt
physicians to include an assessment of personality traits as
well as physical health measurements in determining a patient's
overall risk for heart disease.

"In the future, doctors may wish to explore the use of
earlier interventions aimed at diminishing negative personality
traits in people who may be most at risk for future heart
disease," Suarez said.

Although the study's findings are suggestive, the study had
several limitations, Suarez said. Among them, he said, the
participants were all men, and most of them were white, and so
the findings cannot be generalized with certainty to nonwhites
and females.

His team currently is designing a comprehensive intervention
program to help patients learn to cope with their feelings of
hostility, anger, anxiety and depression as well as reduce
their physical risk factors for heart disease.

"We want to help people at earlier points in their life by
teaching them ways to cope with problems and how to make wiser
choices that promote health," Suarez said. "By helping them
before they ever show clinical signs of heart disease, we may
be able to help them avoid the disease altogether."

Other researchers involved in the study were Stephen Boyle
of Duke University Medical Center and Joel Michalek of the
University of Texas Health Sciences Center at San Antonio.