Bottling up emotions is thought to harm both mind and body,
but a new study suggests that the opposite extreme may be no better.
In a study of
thousands of heart attack patients, those who recalled having flown into a rage
during the previous year were more than twice as likely to have had their heart
attack within two hours of that episode, compared to other times during the
"There is transiently higher risk of having a heart
attack following an outburst of anger," said study author Elizabeth
Mostofsky, postdoctoral fellow with the Cardiovascular Epidemiology Research
Unit at Harvard Medical School in Boston.
The risk of having a
The greater the fury - including throwing objects and
threatening others - the higher the risk, Mostofsky's team reports in The
American Journal of Cardiology. The most intense outbursts were linked to a
more than four-fold higher risk while milder bouts of anger were tied to less
than twice the risk. "The association is consistently stronger with
increasing anger intensity; it's not just that any anger is going to increase
your risk," Mostofsky told Reuters Health.
The data came from a group of 3 886 patients who were part
of a study between 1989 and 1996 to determine what brought on their heart
attacks. Within four days of having a myocardial infarction - the classic
"heart attack" - participants were asked about a range of events in
the preceding year, as well as about their diets, lifestyles, exercise habits
and medication use.
A total of 1 484 participants reported having outbursts of
anger in the previous year, 110 of whom had those episodes within two hours of
the onset of their heart attacks. Participants recalled their anger on a
seven-point scale that ranged from irritation to a rage that caused people to
lose control. The researchers found that with each increment of anger
intensity, the risk of heart attack in the next two hours rose.
Causes of anger
That risk was 1.7 times greater after feeling
"moderately angry, so hassled it shows in your voice;" and 2.3 times
greater after feeling "very tense, body tense, clenching fists or
teeth" and 4.5 times greater after feeling "enraged! lost control,
throwing objects, hurting yourself or others."The most frequent causes of
anger outbursts that participants recalled were family issues, conflicts at
work and commuting.
Although the research cannot prove that the angry outbursts
led to the heart attacks, the results "make sense," according to Dr
James O'Keefe Jr, a cardiologist at St Luke's Hospital in Kansas City who
wasn't involved in the research. Anger is an emotion that releases the
fight-or-flight-response chemicals epinephrine and norepinephrine, he said.
Those hormones raise our blood pressure, our pulse,
constrict blood vessels, make blood platelets stickier (increasing the risk of
blood clots), which O'Keefe says could be one way anger may be associated with
increased heart risk."Contrary to the urban myth that it's best to express
anger and get it out there, expressing anger takes a toll on your system and
there's nothing really cathartic about it," O'Keefe told Reuters Health.
"(Anger) serves no purpose other than to corrode the short and long-term
health of your heart and blood vessels," he said.
In the study, patients on blood pressure medications known
as beta blockers had a reduced chance of having a heart attack following an
angry outburst, Mostofsky's team notes in their report. The authors say that
finding suggests doctors might consider using those drugs preventively in
people at risk of heart attack and prone to anger.
Participants who are
In discussing other possibilities for protecting people at
risk, the researchers also write that during the 1990s when the data were
collected, not enough study participants were on the newer statin drugs to
determine their potential effects on heart attack risk. Similarly, the number
of participants who were on antidepressants was too low to tell whether they
would have made a difference.
Mostofsky and her colleagues write, has been shown to lower overall heart
attack risk. Though they found no differences in the link between angry
outbursts and short-term heart attack risk among regular exercisers in the
study, they conclude that maintaining an active lifestyle couldn't hurt.
The study is part of a broader field of research looking at
managing the effects of emotional states on cardiovascular systems, said Donald
Edmondson, assistant professor of behavioral medicine at Columbia University
Medical Center in New York, who studies heart attack survivors but was not
involved in the new work."People prone to angry outbursts or more broadly,
who are prone to anxiety, depression or other intense emotions should be aware
that this is something that impacts their cardiovascular system,"
(Picture: angry man from Shutterstock)