Hostility Reduction Program to Improve Autonomic Regulation of the Heart
Condition: Hostility; Coronary Arteriosclerosis
MeSH terms: Arteriosclerosis; Coronary Artery Disease; Myocardial Ischemia
Study type: Interventional

Summary: 
      Individuals who experience high hostility levels may be more prone to developing coronary
      artery disease (CAD) than individuals who experience low hostility levels. This study will
      evaluate the effectiveness of a hostility reduction treatment program on the body's ability
      to regulate heart activity in individuals with high levels of hostility.
    

Detailed description: 
      CAD is caused by a narrowing of the blood vessels that supply blood and oxygen to the heart.
      It is the leading cause of death in the United States. Recent evidence has suggested that
      individuals with increased hostility levels have a higher risk of developing CAD than
      individuals with lower hostility levels. The autonomic nervous system (ANS), the involuntary
      part of the nervous system that is responsible for controlling the body's internal
      environment in a coordinated manner, may play a role in CAD development. High levels of
      hostility may elevate ANS activity and increase the release of certain hormones, which in
      turn may lead to hardening of the arteries and CAD. Cognitive behavioral therapy (CBT) has
      been effective for treating individuals with hostility. Through CBT, individuals develop
      coping skills to deal with their anger. This study will evaluate the effect of a CBT
      hostility reduction treatment program on ANS heart regulation and overall CAD risk in
      individuals with high levels of hostility.

      This study will enroll individuals with high levels of hostility. At an initial screening
      visit, potential participants will partake in interviews and complete questionnaires to
      assess hostility levels. Eligible participants will then undergo 24-hour continuous
      electrocardiogram (ECG) monitoring and will complete questionnaires about their surroundings
      and any hostility experienced during the 24-hour period. They will also undergo
      psychophysiological testing, in which responses to a variety of stress-inducing situations
      will be monitored. Participants will then be randomly assigned to either a 12-week CBT
      hostility reduction treatment program or a 12-week wait list control group. Participants in
      the CBT program will attend weekly 75-minute therapy sessions, which will focus on
      relaxation, stress reduction, behavior management, and development of social, communication,
      and coping skills. Hostility levels will be documented each day in a diary. Participants in
      the wait list control group will not take part in any therapy sessions for the initial 12
      weeks. At Week 12, baseline evaluations will be repeated for all participants. The waitlist
      control group will then begin the 12-week CBT program. All participants will attend a 6-month
      follow-up visit for repeat testing.
    

Intervention name(s): CBT Hostility Reduction Program
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single
Primary purpose: Treatment
Keywords: Autonomic Nervous System