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Health, Beauty & Fashion

Angry outbursts may raise risk of heart attack

Bottling up emotions is thought to harm both mind and body but a new study suggests that doing the opposite - having an outburst - may be no better.
The Straits Times - May 23, 2013
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Angry outbursts may raise risk of heart attack

Bottling up emotions is thought to harm both mind and body but a new study suggests that doing the opposite - having an outburst - 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 with other times during the year.

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

The greater the fury - including throwing objects and threatening others - the higher the risk, her team reported 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 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 the onset of their heart attacks within two hours of those episodes.

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. That risk was 1.7 times greater after feeling "moderately angry, so hassled it shows in your voice", 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 outbursts led to the heart attacks, the results make sense, said Dr James O'Keefe Jr, a cardiologist at St Luke's Hospital in Kansas City in the US, who was not involved in the research.

Anger is an emotion that releases the "fight-or-flight response" chemicals epinephrine and norepinephrine, he said.

Those hormones raise the blood pressure and the pulse, constrict blood vessels and make blood platelets stickier (increasing the risk of blood clots), which he said could be one way anger may be associated with increased heart risk.

In the study, patients on blood pressure drugs, known as beta blockers, had a reduced chance of having a heart attack following an angry outburst, the researchers reported.

They said their finding suggests doctors may consider using those drugs preventively in people at risk of heart attack and prone to anger.

In discussing other possibilities for protecting people at risk, the researchers wrote that during the 1990s when the data was 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.

Regular exercise has been shown to lower overall heart attack risk, the researchers said. Although they found no differences in the link between angry outbursts and short-term heart attack risk among regular exercisers as compared with those who were sedentary in the study, they concluded that maintaining an active lifestyle could not hurt.



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