Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: In response to Dr Mann, our earlier
report used the statistical method of generalized estimating equation to examine
the association between baseline hostility score and the average systolic
and diastolic BP levels over 7 years.1 Thus,
that article essentially described a cross-sectional relationship averaged
across years, not a longitudinal relationship. Among the 4 groups (black men,
black women, white men, and white women), the only statistically significant
relationships in average systolic or diastolic BP levels were found in systolic
BP for white men (−0.71 mm Hg per 10-unit difference in hostility score)
and white women (−0.89 mm Hg), both of which were less than 10% of the
standard deviation in systolic BP (10.6 mm Hg). This lack of association between
hostility and BP was found in an earlier cross-sectional analysis of our baseline
data.2 Therefore, we concluded in our previous
article that these data did not support a positive association between baseline
hostility and hypertension. However, we do not agree that hostility was "inversely"
related to BP, as Mann suggests.
Yan LL, Liu K, Daviglus ML, Matthews KA, Kiefe CI. Hostility and Impatience as Risk Factors for Hypertension—Reply. JAMA. 2004;291(6):692. doi:10.1001/jama.291.6.692-b