Newswise — Chronic anger and hostility, or any severe stress, can impair cardiovascular health. None of us totally escapes feeling burdened, stressed, sour, or angry, but new evidence may now help us find the people at most risk, reports the November issue of the Harvard Mental Health Letter.

People with a set of traits known as the Type D ("distressed" ) personality suffer from a high degree of emotional distress, but they consciously suppress their feelings. Early studies show that once Type D's develop coronary artery disease, they are at greater risk of dying, and they often have a poorer quality of life.

How might Type D personality traits contribute to poor heart health? The Harvard Mental Health Letter offers some possibilities:"¢ Stress hormones may be so poorly regulated in Type D's that the heart beats faster, blood pressure rises, blood vessels clench, and extra blood sugar is released. "¢ Type D's may have more active immune systems, and therefore more inflammation, which results in damage to blood vessels and the rupture of atherosclerotic plaques. Platelets may get stickier, and so be more likely to form clots in coronary arteries. "¢ Type D's could have higher concentrations of tumor necrosis factor, a chemical that promotes all these processes.

Studies are needed to determine what effects psychological treatments have on the risks of heart disease. "Whatever its effects on heart disease, psychiatric treatment for Type D patients certainly can relieve anxiety and depression, reduce stress, improve self-esteem, promote better self-care, and ultimately enhance their quality of life," says Dr. Michael Craig Miller, Editor in Chief of the Harvard Mental Health Letter.

Also in this issue:"¢ Treating obsessive compulsive disorder"¢ Results from a survey on mental illness in America today"¢ The effect of childhood trauma on the heart"¢ Is there an autism epidemic? "¢ DHEA for depression

The Harvard Mental Health Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $59 per year. Subscribe at http://www.health.harvard.edu/mental or by calling 1-877-649-9457 (toll free).