Hostile personality and risks of peripheral arterial disease in the general population.

The relationships between personality and risks of coronary heart disease have been studied widely, but little attention has been paid to other forms of atherosclerotic disease. The objective of this study was to determine relationships in the general population between hostile personality and Type A behavior pattern with asymptomatic and symptomatic chronic peripheral arterial disease. The Edinburgh Artery Study comprises a cross-sectional random sample survey of 1592 men and women aged 55 to 74 years sampled from age-sex registers of 10 general practices throughout the city. Peripheral arterial disease was measured using the WHO questionnaire on intermittent claudication, the ankle brachial pressure index, and a reactive hyperemia test. The Bedford Foulds personality deviance questionnaire was used to elicit extrapunitiveness, intropunitiveness, and dominance (including hostile acts); and the Bortner self-administered questionnaire was used to determine Type A/B personality. Hostile acts increased with severity of peripheral arterial disease; there was a mean score of 13.9 in normals and 14.6 in claudicants (p < .05). An increased risk of claudication associated with a one SD increase in hostile acts was significant (p < .05) only in males, odds ratio, 1.41 (95% confidence interval 1.01, 1.96) and was independent of cigarette smoking, alcohol consumption, obesity, and diabetes mellitus. Dominance was also related to asymptomatic peripheral arterial disease in subjects who had neither intermittent claudication nor angina. Contrary to expectations, Type A personality behaviour scores decreased with the severity of peripheral arterial disease. We conclude that hostile personality may be an independent risk factor for chronic peripheral arterial disease in the general population, particularly among men.