High Hostility Linked with Poor Ability to Cope With Stress, Low HDL Levels

Marlene Busko

August 30, 2007

August 30, 2007 — Very hostile older white men were more likely than their less hostile peers to cope poorly with stress and have lower high-density-lipoprotein (HDL), or "good," cholesterol levels, according to a study presented at the American Psychological Association (APA) meeting in San Francisco.

Lead author Loriena A. Yancura, PhD, from the University of Hawaii at Manoa, in Honolulu, told Medscape that this shows that "coping with stress matters, since even in hostile men, positive coping was associated with positive health outcomes and negative coping was associated with negative health outcomes."

The group writes that although studies have shown that hostility affects ability to cope with stress and that both factors are related to lipid levels, few studies have looked at whether different ways of coping with stress make a difference in the relationship between hostility and lipid levels.

The present study looked at the relationships among hostility, ways of coping with stress, and lipid levels.

The researchers analyzed 1988–1991 data from 716 men with a mean age of 65 years who participated in the Normative Aging Study. Most men were white, and the group was evenly split between white- and blue-collar workers.

The current analysis included only men who had a stressful problem in the previous month; their average stress rating was 3.96 on a scale of 1 to 7. The men had an average personality trait hostility score of 16.8 (range, 1 – 44) on the Cook-Medley Hostility Scale, which has a possible score of 1 to 50.

Coping with stress was measured using the Brief Ways of Coping questionnaire, which asks participants to rate how often they use 26 coping strategies. Dr. Yancura explained that the 3 most relevant strategies (and the questions that probed for these strategies) were:

  • Instrumental action: Did you make a plan of action and follow it? Did you just concentrate on what you had to do next — the next step(s)? Did you know what had to be done, so you doubled your efforts to make things work?

  • Self-blame: Did you criticize or lecture yourself? Did you realize that you brought the problem on yourself? Did you make a promise to yourself that things would be different next time?

  • Self-isolation: Did you try to keep others from knowing about the problem? Did you try to keep your feelings to yourself?


Coping Processes May Play Cardioprotective Role

The researchers found that individuals who were very hostile were more likely to perceive problems as stressful and to cope with stress by using interpersonal hostility, self-blame, and social isolation; they also tended to have lower levels of HDL.

In contrast, coping well with stress (for example, by making a plan of action and pursuing it, rather than using self-blame or self-isolation strategies) was linked with higher levels of HDL.

There was no association between coping and low-density-lipoprotein (LDL) levels, and only 1 association between coping and triglycerides; rather the associations were with HDL levels.

"It is interesting that the coping variables were most strongly associated with this protective factor," the group writes. "The results of our study suggest that coping processes also might influence lipid fractions differently and may play a protective role through their influence on HDL," they add.

In a press release issued by the APA, Dr. Yancura says that the group was surprised not to find an association between coping strategies and LDL levels but notes: "We asked people about their coping strategies in response to a problem in the past month and then looked at a blood sample taken at the time we asked them. It is possible that changes in LDL might have been apparent in a lab setting or if we had looked at longitudinal relationships among hostility, coping, and lipids."

The group also observes that their study looked at older white men, and the relationship between psychosocial factors and lipid profiles is likely to be different depending on age, sex, and ethnicity.

American Psychological Association 115th Annual Convention. August 17-20, 2007.


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