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Why getting angry may raise your risk of heart attack - avoid with these Top Ten Tips

Teresa Tanoos's picture
New study says anger may increase risk of heart attack

You may want to put a lid on that anger the next time you feel like lashing out, as thousands of heart attack patients who reported flying into a rage during the preceding year were over twice as likely to have had their heart attack within two hours of their anger outburst.

"There is transiently higher risk of having a heart attack following an outburst of anger," said study author Elizabeth Mostofsky, with the Cardiovascular Epidemiology Research Unit at Harvard Medical School in Boston.

The study, published in The American Journal of Cardiology, also found that the angrier a patient got, the higher their risk of acute myocardial infarction (AMI), commonly known as a heart attack. Indeed, patients who became so enraged that they threw objects, and/or threatened the safety of others, more than quadrupled their risk of getting a heart attack, whereas those who had less intensive outbursts nearly doubled their risk.

"Outbursts of anger are associated with an abrupt increase in cardiovascular events; however, it remains unknown whether greater levels of anger intensity are associated with greater levels of AMI risk or whether potentially modifiable factors can mitigate the short-term risk of AMI," researchers reported.

The researchers’ analyzed data from a group of 3,886 patients who were part of a study between 1989 and 1996 to determine what factors precipitated their heart attacks. Out of all the participants, 38 percent reported outbursts of anger in the previous year. Specifically, 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.

Within four days of having their heart attack, participants were asked questions regarding a variety of events during the previous year, including questions about their diet and exercise, as well as what medications they took and general questions about their lifestyle. Participants were also asked to rate their anger level on a seven-point scale, ranging from mild irritation to a rage that caused them to lose control.

The researchers found that with each increment of anger intensity, the risk of heart attack in the next two hours rose. The participants’ reported that the most common causes of anger outbursts were family issues, conflicts at work and commuting. The researchers also found that beta-blockers decreased the risk of heart attack, as the patients who took them had "a lower susceptibility to heart attacks triggered by anger, suggesting that some drugs might lower the risk from each anger episode."

"The association is consistently stronger with increasing anger intensity; it's not just that any anger is going to increase your risk," lead author Elizabeth Mostofsky told Reuters.

While 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.

According to O’Keefe, anger is an emotion that releases the fight-or-flight-response chemicals epinephrine and norepinephrine – and such chemicals increase blood pressure and pulse, while constricting blood vessels and making blood platelets stickier, increasing the risk of blood clots, which he says could be one way anger is linked to an 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 added.

The best way to lower your risk of getting a heart attack is to participate in a regular exercise program, the researchers’ say. Regular exercise, Mostofsky and her colleagues write, has been shown to lower overall heart attack risk.

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For cardiovascular disease in general, major risk factors include cigarette smoking, high blood pressure, high cholesterol and/or triglycerides, diabetes mellitus, obesity, sedentary lifestyle, and poor nutrition. Prevention and treatment that targets these risk factors can help lower your risk for heart attack and many other types of illness as well, not to mention how it will help you feel your best and have more energy overall.

In the meantime, here is a list of Top Ten Tips to help lower your risk of heart attack and cardiovascular disease:

1. Don't smoke.

2. Lower your cholesterol.

3. Maintain a healthy weight.

4. Exercise regularly.

5. Eat less saturated fat, more produce & more fiber.

6. Avoid trans fats.

7. Consume alcohol only in moderation.

8. Arm yourself with some new stress-management tools.

9. Ask your doctor about taking risk-reducing vitamins.

10. Ask your health professional about herbs and nutritional supplements.

SOURCE: American Journal of Cardiology - May 2, 2013 (10.1016/j.amjcard.2013.03.035)