Cycling Stuff Cycling Wed Healthy Living inflammation

A “good” heart…

This Wednesday it will be easy to combine cycling and medicine.

So it was when I saw this prescient story that linked antagonistic personality traits and cardiovascular risk. It was simply impossible to ignore, especially on a Wednesday. Low hanging fruit, no doubt.

It was an NIH sponsored study which looked at the effects of antagonistic traits, agreeableness per se, on heart health. Yes, you read it right, agreeableness. To quantify agreeableness, these researchers used a personality questionnaire which included six traits: trust, straightforwardness, altruism, compliance, modesty and my favorite, tender-mindedness.

Your hypothesis is probably right: people who were distrustful, cynical, manipulative, self-centered and quick to express anger fared worse. Don’t worry cyclists, these are not your traits. Ha! Wink.

Please, do not dismiss this as just another mundane study proclaiming the risks of an angry personality. The specifics of the findings, and their implications hit really hard.

The researchers studied 5600 patients from Sardinia, Italy.  They used carotid (neck) artery thickness as a surrogate measure of vascular health. (Obviously, a thicker vessel wall is worse.  Also, on average men have thicker-walled carotid arteries than women.)   There were four striking findings..

  • Low agreeableness scores were associated with thicker-walled arteries, and an increased likelihood of progressive thickening over a three year span.
  • Poor agreeableness scores were more pronounced in women. So much so that, women with really low agreeableness scores showed showed artery thickness values the same as men. In other words, being a highly disagreeable women may risk transforming the favorable female artery to the less desirable male one. (I am not making this up.)
  • Straightforwardness and compliance were the specific traits that correlated most with artery wall thickness.
  • The wake-up and pay attention take home message is that the increased CV risk of antagonistic traits are similar in magnitude to the risk of high cholesterol, high blood pressure and even smoking. Statistically speaking, being disagreeable was as bad as being a smoker, or having high blood pressure or high cholesterol.

There are caveats here. This is a population based study, not a randomized prospective trial. Also, it is a select population in one area of Italy. Finally, this study used a surrogate endpoint for heart disease, rather than hard endpoints like heart attack and stroke.

Nonetheless, I predict that in the future, the health of the “spiritual” heart will be scientifically linked with the health of the “biologic” heart.  And this link will likely be where the “rubber meets the road,” where the platelets hit the vessel wall, the endothelium.  At least when it comes to inflammation and heart health, Gramps may have been wrong when he frequently said, “nice guys always finish last.”

Eat well, sleep well, move a lot, and now, be agreeable, straightforward, and even tender-minded, should be the advice of doctors to patients who wish to minimize their cardiac risk profile.

Cyclists, you have no need to worry, I can vouch for your tender-mindedness.


h/t to Larry Husten, editor of the outstanding cardiovascular news site, CardioBrief, where I read this story first. 

Medpage also has a very nice summary of the study details.