Clinical Trial: Hostility, Depression, Social Environment and CHD Risk

This study is no longer recruiting patients.

Sponsored by: National Heart, Lung, and Blood Institute (NHLBI)
Information provided by: National Heart, Lung, and Blood Institute (NHLBI)


To examine the separate and interactive effects of hostility, depressive symptomatology and socioeconomic status (SES) in predicting coronary heart disease risk.

Cardiovascular Diseases
Coronary Disease
Heart Diseases

MedlinePlus related topics:  Coronary Disease;   Depression;   Heart Diseases;   Heart Diseases--Prevention;   Vascular Diseases

Study Type: Observational
Study Design: Natural History

Further Study Details: 

Study start: February 1997;  Study completion: July 2004

BACKGROUND: Hostility, depression/depressive personality, and socioeconomic status (SES) have all been shown to influence the risk of coronary heart disease (CHD). While the three factors have been studied separately in previous work, there is evidence that they are interrelated and there is reason to hypothesize that they would interact in a multiplicative fashion to dramatically increase risk when they are present in combination.

DESIGN NARRATIVE: Three studies are conducted that are designed to describe the interrelationships of hostility, depression/depressive personality, and socioeconomic status and document their joint impact on several health outcomes. Study 1 takes advantage of two existing databases to study over 3000 coronary artery disease patients who have been followed for over a decade. Both self-report and behavioral indicators of hostility and depression are studied in combination with SES to predict survival while controlling for initial disease severity. These measures are also used in analyses designed to discriminate the psychosocial profile of patients who died early in follow-up from those who died after five years. Data on health behavior profiles and medical care utilization are examined to evaluate the possibility that those factors could account for the relationships between psychosocial characteristics and survival.

Study 2 examines the ability of depressive personality, hostility, and SES to jointly predict acute myocardial infarction (AMI) and mortality in a sample of 730 initially healthy people who have been followed for 30 years. It also investigates the associations of these psychosocial measures with changes in risk factor patterns and health indicators over the follow-up period.

Study 3 administers a large battery of measures to community volunteers in order to document the interrelationships between hostility, depressive personality, and SES in detail. These measures are also used to predict the magnitude and duration of cardiovascular reactivity to mood induction tasks.

The study was renewed in FY 2000 to continue data analysis.


Genders Eligible for Study:  Male


No eligibility criteria

Location Information

Study chairs or principal investigators

John Barefoot,  Duke University   

More Information


Brummett BH, Barefoot JC, Feaganes JR, Yen S, Bosworth HB, Williams RB, Siegler IC. Hostility in marital dyads: associations with depressive symptoms. J Behav Med. 2000 Feb;23(1):95-105.

Brummett BH, Babyak MA, Barefoot JC, Bosworth HB, Clapp-Channing NE, Siegler IC, Williams RB Jr, Mark DB. Social support and hostility as predictors of depressive symptoms in cardiac patients one month after hospitalization: a prospective study. Psychosom Med. 1998 Nov-Dec;60(6):707-13.

Brummett BH, Maynard KE, Haney TL, Siegler IC, Barefoot JC. Reliability of interview-assessed hostility ratings across mode of assessment and time. J Pers Assess. 2000 Oct;75(2):225-36.

Barefoot JC, Brummett BH, Clapp-Channing NE, Siegler IC, Vitaliano PP, Williams RB, Mark DB. Moderators of the effect of social support on depressive symptoms in cardiac patients. Am J Cardiol. 2000 Aug 15;86(4):438-42.

Brummett BH, Barefoot JC, Siegler IC, Clapp-Channing NE, Lytle BL, Bosworth HB, Williams RB Jr, Mark DB. Characteristics of socially isolated patients with coronary artery disease who are at elevated risk for mortality. Psychosom Med. 2001 Mar-Apr;63(2):267-72.

Barefoot JC, Brummett BH, Helms MJ, Mark DB, Siegler IC, Williams RB. Depressive symptoms and survival of patients with coronary artery disease. Psychosom Med. 2000 Nov-Dec;62(6):790-5.

Barefoot JC, Mortensen EL, Helms MJ, Avlund K, Schroll M. A longitudinal study of gender differences in depressive symptoms from age 50 to 80. Psychol Aging. 2001 Jun;16(2):342-5.

Barefoot JC, Gronbaek M, Feaganes JR, McPherson RS, Williams RB, Siegler IC. Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study. Am J Clin Nutr. 2002 Aug;76(2):466-72.

Brummett BH, Babyak MA, Mark DC, Williams RB, Siegler IC, Clapp-Channing N, Barefoot JC. Predictors of smoking cessation in patients with a diagnosis of coronary artery disease. J Cardiopulm Rehabil. 2002 May-Jun;22(3):143-7.

Surwit RS, Williams RB, Siegler IC, Lane JD, Helms M, Applegate KL, Zucker N, Feinglos MN, McCaskill CM, Barefoot JC. Hostility, race, and glucose metabolism in nondiabetic individuals. Diabetes Care. 2002 May;25(5):835-9.

Fredrickson BL, Maynard KE, Helms MJ, Haney TL, Siegler IC, Barefoot JC. Hostility predicts magnitude and duration of blood pressure response to anger. J Behav Med. 2000 Jun;23(3):229-43.

Williams RB, Barefoot JC, Schneiderman N. Psychosocial risk factors for cardiovascular disease: more than one culprit at work. JAMA. 2003 Oct 22;290(16):2190-2. No abstract available.

Matthews KA, Gump BB, Harris KF, Haney TL, Barefoot JC. Hostile behaviors predict cardiovascular mortality among men enrolled in the multiple risk factor intervention trial. Circulation. 2004 Jan 6; 109(1): 66-70. Epub 2003 Dec 08.

Study ID Numbers:  5066
Record last reviewed:  July 2004
Last Updated:  October 13, 2004
Record first received:  May 25, 2000 Identifier:  NCT00005533
Health Authority: United States: Federal Government processed this record on 2005-04-08

Cache Date: April 9, 2005