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February 11, 2004

Hostility and Impatience as Risk Factors for Hypertension—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(6):692. doi:10.1001/jama.291.6.692-b

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.