PS Calhoun, Durham VAMC; HB Bosworth, Durham VAMC; IC Siegler, Duke University; LA Bastian, Durham VAMC

Objectives: While previous research has generally supported a relationship between hostility and health risk behaviors, the majority of this research has been conducted in predominately male, highly-educated, Caucasian samples. The relationship between hostility and health risk behaviors in women has received less attention and no studies have examined this relationship in women veterans. The current study was designed to

further examine the relationship between hostility and health risk behaviors in a sample of women veterans receiving VA care.

Methods: Measures of health risk behavior and scores from the Cook-Medely hostility scale were obtained cross-sectionally from 409 women veterans, mean age 50.7 years, range 35-81, receiving primary care at the Durham VAMC. Thirty-three percent of the women were African-American. Linear and logistic regression analyses were used to examine the relationship between hostility and health risk behaviors after accounting for sociodemographic factors including age, race, education, and income. Health risk behaviors included a lack of exercise, tobacco smoking, alcohol use, caffeine use, and body-mass index (BMI), which have been previously associated with cardiovasculardisease and other health outcomes.

Results: Examining the prevalence of health risk behaviors in the cohort of women veterans using VA health care, 23% were current smokers, 47% were obese (BMI>29), 23% did not exercise, 14% consumed excessive amounts of caffeine, and 52% reported drinking alcohol. Several relationships were found between sociodemographic variables and risk behaviors. While African-American women were more likely to be obese OR=1.87, 95% CI=1.20, 2.91) they were less likely to drink alcohol OR=0.61, CI=0.39, .96) or use excessive amounts of caffeine (OR=.18, CI=0.08,0.42). Women with more than a high school education were significantly less likely to smoke as compared to women with less formal education (OR=0.47, 95% CI=.24, .91). After accounting for race, education, income, and age, hostility was significantly associated with tobacco smoking (OR=2.10, 95% CI= 1.34, 3.30), caffeine use (OR=2.12, 95% CI= 1.16, 3.85), and the number of alcoholic beverages consumed by women who drink alcohol (p<.05). Hostility was not associated with BMI, the prevalence of alcohol use,or a lack of physical exercise.

Conclusions: Among women veterans, hostility is associated with increased smoking,caffeine use, and the amount of alcohol consumed by women who drink. Results are consistent with previous research conducted in relativelymore homogeneous samples and support the relationship between hostility and health risk behaviors.

Impact: Hostility has been identified as an independent risk factor for coronary artery disease which is the leading cause of death among women in the United States. Mortality trends for cardiovascular disease in women are on the rise. This study suggests that hostility among women veterans may lead to increased risk of cardiovascular disease through its impact on health risk behaviors such as smoking. Awareness that hostility contributes to risk behaviors and disease may help in the design of interventions aimed at risk reduction.