Anger-coping types, blood pressure, and all-cause mortality: a follow-up in Tecumseh, Michigan (1971-1983).
Level 3 - non-randomized controlled study
Prospective observational cohort follow-up study
PubMed 3728438 · doi:10.1093/oxfordjournals.aje.a114380
What was done
A prospective cohort study examined 696 men and women aged 30–69 from the Tecumseh Community Health Study followed from 1971 to 1983 (12-year follow-up). Baseline anger-coping types (anger suppression vs. expression) were evaluated using hypothetical scenarios involving an unjustified confrontation by a spouse or a police officer. The outcome was all-cause mortality, adjusted for baseline age, sex, education, smoking, relative weight, blood pressure, coronary heart disease status, FEV1, and chronic bronchitis.
What was found
Individuals who suppressed anger in response to two hypothetical situations had a 1.7 times higher mortality risk compared to those who expressed anger (95% CI: 1.03–3.05). Suppressing anger when confronted by a spouse was associated with twice the mortality risk (95% CI: 1.13–3.38). Suppressing anger toward a police officer yielded a relative risk of 1.24 (95% CI: 0.72–2.14). These associations remained after multivariable adjustment, and suppressed anger significantly interacted with elevated blood pressure to predict the highest risk of mortality.
Why it matters
This study provides prospective evidence linking psychological coping styles—specifically habitual anger suppression—to long-term all-cause mortality, particularly in individuals with elevated blood pressure.
Limits
The sample was derived from a single community (Tecumseh, Michigan), which may limit generalizability. Anger-coping responses were assessed through self-report on hypothetical scenarios rather than real-world behavioral observations, and potential changes in coping mechanisms or medical risk factors over the 12-year follow-up were not accounted for.
Cited by
- partial In research on Type A personality and cardiovascular disease, individuals who suppress and hold their emotions inside have higher early heart attack mortality compared to those who express emotions outwardly.