SUPPRESSED ANGER, BLOOD PRESSURE AND MORTALITY FOLLOW-UP

本研究的主要目的是重新审视两者的关系

The major aim of this research is to re-examine the relationship between suppressed anger, elevated blood pressure and all-cause as well as coronary heart disease (CHD) mortality using data from the Life Change Event Study (LCES) conducted on a representative sample of the Tecumseh Community Health Study (TCHS), n=696, men and women, aged 30-69 in 1971-1972. The psychosocial data (e.g. anger-expression, stressful life events) and some medical data (e.g. blood pressure, smoking) were collected in 1971/72, while additional information about other medical risk factors was collected in 1968/69. Mortality ascertainment and cause of death will be completed by the end of 1989, through TCHS staff, using the National Death Index (NDI). The estimated cumulative 18-year mortality rate as of 1989 for the Tecumseh cohort of the same age as the LCES sample is 26 percent for males and 16 percent for females. Approximately 144 deaths are expected. Out of the total TCHS cohort deaths, 35 percent are estimated to be due to CHD. Research questions to be tested are: (1) does suppressed anger predict CHD mortality as well as all-cause mortality; (2) is the relationship between suppressed anger and mortality modified by other risk factors (e.g. blood pressure, marital stress, gender); (3) are there certain anger-coping strategies among married couples which increase mortality risk for one or both members of the marital pair. Analyses will be done at three levels: for the whole sample, separately for males and females, and for a subgroup of 192 married couples it will be done by 'pairs'. To determine univariate association between anger-coping types and all-cause mortality, the percent deceased will be compared among persons grouped according to their anger responses. For the situation-specific and total suppressed anger indices, the distribution of scores will be divided into thirds. The significance of each association will be tested using chi-square statistics. Logistic regression will be employed to test for the significance of the association between anger-coping measures and mortality controlling for sex, age, education, marital stress, relative weight, smoking, systolic blood pressure, CHD status, bronchitis, and FEV1 scores. Logistic regression will also be used to determine whether any of the risk factors, particularly blood pressure, gender and marital stress, significantly modify the relationship between suppressed anger and mortality. The design and measures of this study have the potential to further identify specific person-situation characteristics that are associated with higher risks of total as well as cause specific mortality which then can be used to make more knowledgeable recommendations for health behavior interventions.