Can an outburst of anger affect the heart?
Previous research has suggested that there is a link between an acute episode of anger and an increased risk of heart attack. Researchers at Columbia University Irving Medical Center, Yale School of Medicine, St. John’s University in New York and other institutions wanted to find out why.
To answer that question, they would need to piss off some people.
The researchers recruited 280 healthy young adults and randomized them into four groups: a control group that counted aloud for eight minutes and maintained a neutral emotional state, and groups that recalled events that made them angry, sad or anxious. Before they began, and at 100-minute intervals afterward, the researchers collected blood samples and measurements of blood flow and pressure.
The findings, published Wednesday in the Journal of the American Heart Association, show that anger can indeed affect the heart because of the way it impairs the functioning of blood vessels.
The researchers found that the ability of blood vessels to dilate was significantly reduced among people in the angry group compared to those in the control group. Blood vessel dilation was not affected in the sadness and anxiety groups.
Dilation can be regulated by endothelial cells, which line the inside of blood vessels. By dilating and contracting, blood vessels decrease or increase the flow of blood to the parts of the body that need it.
Additional testing revealed that there was no damage to the endothelial cells or to the body’s ability to repair any damage to the endothelial cells.
The only problem was dilation, the study found. Deterioration in the dilation of blood vessels is an early marker of atherosclerosis, which is the accumulation of fats and cholesterol, called plaque, on the walls of the arteries that make them stiff. Atherosclerosis can cause coronary heart disease, heart attack, stroke and kidney disorders.
“This is why endothelium-dependent vasodilation is an important mechanism to study,” said co-author Andrea Duran, assistant professor of medical sciences at Columbia University Irving Medical Center, using medical terminology for the deficiency observed in the study.
The study results could help doctors persuade their patients who have heart disease and anger problems to control their anger through yoga, exercise, cognitive behavioral therapy or other established techniques, said Dr. Holly Middlekauff, a cardiologist. and professor of medicine and physiology at the David Geffen School of Medicine at UCLA.
“It is not widely known or widely accepted that anger precipitates heart attacks,” said Middlekauff, who was not involved in the study. “This study offers biological plausibility to this theory, that anger is bad, that it increases blood pressure, that we are seeing vascular health problems.”
And that may draw some patients’ attention, she added.
Duran warned that the laboratory study is essential and that more research is needed. For example, scientists don’t know exactly how anger impairs blood vessel dilation. “That would be for a future study,” she said.
In the paper, the researchers suggested that several factors could be at work, including changes caused by stress hormones, increased inflammation and activation of the autonomic nervous system, which regulates involuntary processes such as heart rate, blood pressure and breathing.
Additionally, the researchers intentionally selected healthy participants without heart disease or other chronic conditions that could confound the results. While this is a strength of the study, it is also a limitation because the results may not apply to older people who are sick.
“This was just the first step,” said Rebecca Campo, a psychologist and program director at the National Heart, Lung and Blood Institute, which funded the study.
Future research should analyze “populations with cardiovascular diseases, diabetes and people living in rural environments and ethnic and racial minorities”.
Middlekauff said the study’s biggest limitation is that it looked at an provoked tantrum.
“I would like to see a study of a group of people with chronic anger and see what their vascular function is,” she said.
