Autoimmune Thyroid Disease

An Unfortunate and Lengthy Adventure in Misdiagnosis

Media claims anger damages lung function

with 2 comments

One of the first, most basic rules of science is this: correlation does not equal causation! This little vignette has been posted all over the internet in the last couple of days:

An eight-year study of 670 men aged 45 to 86 showed that anger and hostility can speed up the rate at which lung power declines with age.

Men with higher levels of long-standing anger at the study’s beginning had significantly poorer lung function by the end.

The researchers rated anger levels with a scoring system. Lung power was tested three times over the course of the study.

Even after taking into account other factors, such as smoking, the hostility and anger affected lung function.

Anger, hostility and stress have previously been associated with heart disease, asthma and other illnesses. The emotions may change biological processes, disturbing the immune system and causing chronic inflammation. Anger can damage your lungs

Anger can damage your lungs? Please. Let’s find out more about what the media are saying:

LONDON (Reuters) – Lung power normally declines as a person ages but being angry and hostile can speed up the process, researchers said on Thursday.

In a study of 670 men ranging in age from 45 to 86, they found that males who had higher levels of long-standing anger at the start of the eight-year project had significantly poorer lung function at the end of it.

“This study is one of the first to show prospectively that hostility is associated with poorer pulmonary function and more rapid rates of decline among older men,” said Dr Rosalind Wright, of Harvard School of Public Health in Boston, Massachusetts, in a report online in the journal Thorax.

The scientists used a scoring system to measures the levels of anger of each of the men and they tested their lung power three times during the study.

Even after taking account of other factors such as smoking that can also have an impact on lung power, hostility and anger had a negative effect.

Anger, hostility and stress have also been associated with heart disease, asthma and other ailments.

Wright and her team suggested that the negative emotions could change biological process and may disturb the immune system and cause chronic inflammation.

“Stress-related factors are known to depress the immune function and increase susceptibility to or exacerbate a host of diseases and disorders,” said Dr Paul Lehrer, of the University of Medicine and Dentistry of New Jersey, in an editorial in the journal.

He added that it is unknown how chronic anger contributes to physical deterioration but said the researchers established a link between chronic anger and age-related deterioration in lung function.

“The next step is to determine the exact pathway by which this happens,” said Lehrer. Anger speeds up deterioration of lungs: study

So this seems pretty damning: boffins say anger damages the lungs. But two weeks ago this article appeared on the BBC news site:

[…] The volunteers had had their levels of hostility measured in 1986 through a series of questionnaires, which indicated their longer term emotional state, the researchers said.

Their lung function was also measured and then analysed at routine intervals over an average period of just over eight years.

Dr Rosalind Wright of Harvard Medical School, who led the research, said: “The men with higher levels of hostility had lower lung function at this baseline point in 1986, but they also showed a more rapid rate of decline over time.”

Other studies had shown that a rapid decline in lung function was linked to increased susceptibility to debilitating lung diseases, such as chronic obstructive pulmonary disease (COPD) and cardiovascular disease, and increased mortality.

But she said that, because the group were all ex-military, mainly white and of a lower socio-economic status, the findings could not be applied to the wider population.

The researchers believe that anger and hostility could be affecting neurological and hormonal processes, which in turn could cause chronic inflammation in some of the body’s systems, such as the lungs.

However, Dr Wright said the study showed an association between anger and lung disease, rather than a cause and effect relationship.

She said: “Healthcare providers should be aware that your emotional state can play a role in lung health over time.

“It could change the way we think about screening for risk factors and could inform different types of interventions – such as cognitive behavioural therapy.

Dr John Moore-Gillon, a lung specialist and spokesman for the British Thoracic Society, said: “This is a fascinating piece of work.

“There does seem to be a link between long-term anger and hostility and decline in the functioning of the lungs.

“Whether the decline is actually caused by the emotion or whether they are both caused by a third, unrecognised factor is not yet certain.

“The research highlights our growing awareness of the close links between the mind and the body, and the years to come may lead to further important insights.” Anger ‘compromises lung function’

Did you catch those throwaway lines in the middle of this article? However, Dr Wright said the study showed an association between anger and lung disease, rather than a cause and effect relationship. […] “Whether the decline is actually caused by the emotion or whether they are both caused by a third, unrecognised factor is not yet certain.”

If we go back to the study abstract, the study draws no such conclusions that “anger damages lungs”:

Background: Hostility and anger are risk factors for, or co-occur with many health problems of older adults, such as cardiovascular diseases, all-cause mortality, and asthma. Evidence that negative emotions are associated with chronic airways obstruction suggests a possible role for hostility in the maintenance and decline of pulmonary function. This study tests the hypothesis that hostility contributes to faster rates of decline in lung function among older adults.

Methods: This study prospectively examines the effect of hostility on lung function change over time. Data are from the V.A. Normative Aging Study, an ongoing cohort of older men. Hostility was measured in 1986 in 670 men who also had an average of 3 pulmonary function exams, obtained over an average of 8.2 years of follow-up. Hostility was ascertained using the 50-item MMPI-based Cook Medley Hostility Scale. Pulmonary function was assessed using spirometric tests to obtain measures of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC).

Results: Baseline pulmonary function differed across high and medium/low hostility groups (percent predicted FEV1 88.9 + or – 18.5 vs. 95.3 + or – 16.9 and FVC 92.5 + or – 16.5 vs. 98.9 + or – 15.9 respectively; p’s Angry breathing: a prospective study of hostility and lung function in the Normative Aging Study

So if anger is not playing a causative role, what could be the third, unrecognised factor? Here’s a clue: “Anger, hostility and stress have previously been associated with heart disease, asthma and other illnesses.”

Now, what could possibly on this planet cause a correlation between asthma and anger? Could it – shock horror – have something to do with most asthmatics being sensitive to food chemicals? That common emotional reactions to food chemicals include anger, hostility, and depression? Give me strength! How are we ever to join up the dots when our medical researchers are so specialised in their knowledge that they don’t even know which search words to type into medline in order to get out a sensible answer?

Allergic-like reactions to chemical components of foods and medicines may be common. The prevalence of idiosyncratic reactions to aspirin, salicylate, metabisulfite and tartrazine is not known. We used a tertiary referral clinic population to estimate safe exposure doses for epidemiological studies. A 15% decrease in the amount of air expired in one second was defined a positive response. The median effective molar doses of the agents were remarkably similar: metabisulfite 0.19 mM, 34.4 mg [95% confidence interval (CI) 0.14, 0.27 mM]; tartrazine 0.10 M, 55.0 mg (95% CI 0.05, 0.21 mM); aspirin 0.09 mM, 16.5 mg (95% CI 0.04, 0.19 mM); and salicylate 0.11 mM, 15.3 mg (95% CI 0.05, 0.27 mM). Doses to which the most sensitive (5%) and practically all (95%) susceptible persons might respectively respond are: metabisulfite 4.6 mg, 255.8 mg; tartrazine 3.4 mg, 885.6 mg; aspirin 0.8 mg, 332.3 mg; and salicylate 2.6 mg, 89.9 mg. Doses within these ranges can be used in epidemiological studies. Aspirin, salicylate, sulfite and tartrazine induced bronchoconstriction. Safe doses and case definition in epidemiological studies. Corder EH, Buckley CE 3rd, J Clin Epidemiol 1995 Oct;48(10):1269-75


Written by alienrobotgirl

14 September, 2006 at 8:57 am

2 Responses

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  1. .You have an unexcelled blog and certainly may set it up any way that you desire however isn’t it a bit of overkill to havecomment moderation as well as word verification unless you really don’t wishfor anyone to leave comments on your distinguished blog???My blog only has comment moderation – Am I losing anything???Dr. WhoamiP.S. Besides Google’s word verification is driving me to becoming dyslexic – a problem I never had before…

    Dr. WhoAmI

    16 September, 2006 at 1:10 am

  2. Hi Dr WhoAmI… Good point, however, I’ve been subjected to several extreme cases of automated comment-spam in the past, and I just don’t have the hours of the day available to keep track and delete them all!

    Alien Robot Girl

    16 September, 2006 at 2:00 pm

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