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Do You Have A “Good” Heart?

I saw a prescient story that linked antagonistic personality traits and cardiovascular risk. It was simply impossible to ignore. Low hanging fruit, no doubt.

The article highlights an NIH-sponsored study [published in the August 16th journal Hypertension] that looked at the effects of antagonistic traits — agreeableness, per se — on heart health. Yes, you read it right — agreeableness. To quantify agreeableness, the researchers used a personality questionnaire which included six traits: Trust, straightforwardness, altruism, compliance, modesty, and my favorite…tender-mindedness.

Your hypothesis is probably right: People who were distrustful, cynical, manipulative, self-centered, and quick to express anger fared worse. But please don’t dismiss this as just another mundane study proclaiming the risks of an angry personality. The specifics of the findings and their implications really hit hard.

The researchers studied 5,600 patients from Sardinia, Italy. They used carotid (neck) artery thickness as a surrogate measure of vascular health. (Obviously, a thicker vessel wall is worse. Also, on average men have thicker-walled carotid arteries than women.)  There were four striking findings:

  • Low agreeableness scores were associated with thicker-walled arteries, and an increased likelihood of progressive thickening over a three-year span.
  • Poor agreeableness scores were more pronounced in women. So much so that, women with really low agreeableness scores showed artery thickness values the same as men. In other words, being a highly-disagreeable woman may risk transforming the favorable female artery to the less desirable male one. (I’m not making this up.)
  • Straightforwardness and compliance were the specific traits that correlated most with artery wall thickness.
  • The “wake up and pay attention” take-home message is that the increased cardiovascular risk of antagonistic traits are similar in magnitude to the risk of high cholesterol, high blood pressure, and even smoking. Statistically speaking, being disagreeable was as bad as being a smoker or having high blood pressure or high cholesterol.

There are caveats here. This is a population-based study, not a randomized prospective trial. Also, it’s a select population in one area of Italy. Finally, this study used a surrogate endpoint for heart disease rather than hard endpoints like heart attack and stroke.

Nonetheless I predict that in the future the health of the “spiritual” heart will be scientifically linked with the health of the “biologic” heart. And this link will likely be where the “rubber meets the road,” where the platelets hit the vessel wall (the endothelium). At least when it comes to inflammation and heart health, Gramps may have been wrong when he said, “Nice guys always finish last.”

“Eat well, sleep well, move a lot, and be agreeable, straightforward, and even tender-minded,” should be the advice of doctors to patients who wish to minimize their cardiac risk.


Hat tip to Larry Husten, editor of the outstanding cardiovascular news site, CardioBrief, where I first read this story. 

MedPage also has a very nice summary of the study details.

*This blog post was originally published at Dr John M*

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