CARDIAC AUTONOMIC CONTROL AND HOSTILITY IN HEALTHY-SUBJECTS

Disordered autonomic regulation of the cardiovascular system has been implicated in sudden cardiac death and coronary artery disease in numerous studies. Bigger et al1 showed that survival after myocardial infarction was predicted by high-frequency (HF) power of the heart period power spectrum, a measure of vagal modulation of RR intervals,2 by power in other frequency bands, and by the low-frequency (LF) to HF power ratio, a measure that has been used to estimate sympathovagal balance. Increased heart rate, reflecting global cardiac autonomic control, is associated with development of atherosclerosis in animal models3 and age-adjusted levels of atherogenic lipoproteins in humans.4 Heart rate-lowering interventions such as surgical ablation of the sinoatrial node and β-adrenergic antagonists have antiatherogenic effects.3. Cardiovascular regulation by the autonomic nervous system may link negative personality characteristics, e.g., hostility, with increased risk of coronary artery disease, an association generally supported by available data.5,6 Two views about the nature of the link, the constitutional and the transactional theories, specify different mechanisms. The constitutional theory holds that the autonomie activity associated with risk of coronary artery disease is caused by a constitutional characteristic which also accounts for hostility.5 In this view, hostility is a marker of factors that influence brainstem cardioregulatory centers. The transactional theory holds that hostile persons interact with their environment in a way that creates interpersonal conflict and reduces social support.5 Since in laboratory experiments, psychological Stressors decrease HF power in the heart period power spectrum,7 the stressfulness of the transactions that persons high in hostility have with their interpersonal environments suggests an inverse relation between hostility and HF power, which in turn may increase risk of coronary artery disease. © 1994.