Thursday, August 23, 2007

The role of hostility, anger, and depression in inflammation

Hasn't it "always" been known that anger and hostility raises one's blood pressure? However that may be, a recent study shows that the connection of hypertension with chronic anger and hostility may involve a disturbed immune system and inflammation – in addition to the well-known blood vessel constriction that is a part of the "fight or flight" stress response.

Hostile Men Could Have Greater Risk For Heart Disease
Men who are hostile and prone to frequent intense feelings of anger and depression could be harming their immune systems and putting themselves at risk for coronary heart disease as well as related disorders like type 2 diabetes and high blood pressure, a new study finds.

The results were found in a 10-year study of U. S. veterans of the Vietnam war.
The men had a series of blood levels taken on three occasions between 1992 and 2002. Researchers measured two immune system proteins known as C3 and C4. Both are markers of inflammation, which is the body’s response to injury or infection. Changes in C3 and C4 are associated with a number of diseases, including some that negatively can affect the arteries around the heart, such as diabetes.

Men whose psychological screening showed the highest level of hostility, depressive symptoms and anger had a 7.1 percent increase in their C3 levels, while men with low levels of these attributes showed no change over the 10-year study period.

Here's another report on this research: Hostility, anger linked to chronic inflammation

But a 2004 study had already demonstrated a stronger correlation between psychological variables and a marker of inflammation (C-reactive protein):

Anger, Hostility And Depressive Symptoms Linked To High C-reactive Protein Levels
Researchers at Duke University Medical Center have discovered that otherwise healthy people who are prone to anger, hostility and mild to moderate depressive symptoms produce higher levels of a substance that promotes cardiovascular disease and stroke.

The substance, C-reactive protein (CRP), has garnered considerable attention for its role in both promoting and predicting cardiovascular disease and stroke in initially healthy people. It is produced by the liver in response to inflammation, and inflammation has recently been shown to underlie the plaque that forms inside arteries as they clog.

The Duke study is the first to link this combination of negative psychological attributes with higher levels of CRP in people without traditional risk factors for heart disease...

More specifically,
121 healthy men and women were asked to complete standard personality questionnaires in which they described their psychological attributes, including anger, hostility and depression. The volunteers did not have any pre-existing conditions -- such as smoking, high blood pressure, diabetes or heart disease -- that would predispose them to having high CRP levels. High-sensitivity blood tests were then conducted to measure CRP levels.

Respondents who were prone to anger, had high hostility levels, and showed mild to moderate symptoms of depression had two to three times higher CRP levels than their calmer counterparts. The more pronounced their negative moods, the higher CRP levels they had, the study showed.

In addition, the researcher had previously shown a relation between the psychological variables and another inflammatory substance (interleukin-6):
[H]ostile people who exhibit symptoms of depression have higher levels of stress hormones and circulating levels of an inflammatory substance called interleukin 6, another marker of inflammation that has been shown to predict heart disease in initially healthy people.

A number of other studies have demonstrated relationships between psychological stress conditions and disease states that involve the immune system, such as this one from 2006:

Anger And Hostility Speed Up Decline In Lung Power
The authors point out that hostility and anger have been associated with cardiovascular disease, death, and asthma, and that previous research has suggested that changes in mood can have short term effects on the lungs.

Anger and hostility will alter neurological and hormonal processes, which in turn may disturb immune system activity, producing chronic inflammation, suggest the authors.

An accompanying editorial comments that the physiological components of anger and stress overlap, and stress is well known to affect the immune system.

Bottom line: Get control over anger and depression if you want to stay healthy.

Of course, this is all closely related to what I discussed just a couple of weeks ago on stress and weight gain and in particular the extensive research of Robert Sapolsky summarized here.

Additional references:

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