‘Angry outbursts increase risk of heart attacks’

Outbursts of anger may trigger heart attacks, strokes and other cardiovascular problems in the two hours immediately afterwards.

The finding emerged from the first study that evaluated previous research on the link between extreme emotion and all cardiovascular outcomes.

The study, published today in the European Heart Journal, found that in the two hours immediately after an angry outburst there was a fivefold increase of a heart attack.

The risk of stroke increased more than three-fold.

One of the researchers, Dr Elizabeth Mostofsky, from the Harvard School of Public Health in Boston in the US, said the risk accumulates for people who get angry frequently.

“This is particularly important for people who have higher risk due to other underlying risk factors, or those who have already had a heart attack, stroke or diabetes,” she said.

Dr Mostofsky and her colleagues calculated that one extra heart attack per 10,000 people per year could be expected among people with low cardiovascular risk who were angry only once a month.

However, the risk increased to an extra four per 10,000 people with a high cardiovascular risk.

Five episodes of anger a day would result in around 158 extra heart attacks per 10,000 people with a low cardiovascular risk per year, increasing to around 657 extra heart attacks per 10,000 among those with a high cardiovascular risk.

The researchers say that their results do not necessarily indicate that anger causes the cardiovascular problems, only that they are associated with them. However, they found that the results were fairly consistent across the studies even though they were conducted over more than 18 years in different countries and groups of people.

Researchers looked for studies carried out between January 1966 and June 2013 on the links between anger and a range of cardiovascular outcomes. The researchers say there are several potential mechanisms linking anger outbursts and cardiovascular problems.

Psychological stress has been shown to increase heart rate and blood pressure and vascular resistance. changes in blood flow can cause blood clots and may stimulate inflammatory responses. The researchers believe more research is needed to determine the effectiveness of psychosocial interventions to prevent cardiovascular events such as heart attack and stroke.