Keep calm and carry on (living)

3 minute read

New research finds a biological mechanism for why anger leads to heart attacks and strokes.

Having a short temper could dramatically shorten your lifespan.

Doctors have long known negative emotions such as anxiety, anger and sadness are associated with an increased risk of cardiovascular disease events like heart attacks or strokes – but how an emotional reaction translates into physical symptoms hasn’t always been well understood.

A new American study suggests getting angry negatively impacts the health of endothelial cells, which form the inner lining of blood vessels, leading to vessel construction and reduced blood flow. The findings were published in the Journal of the American Heart Association.

Columbia University researchers recruited 280 healthy volunteers aged 18 to 73 years, who visited the lab and were randomly allocated into one of four emotional conditions (anger, anxiety, depressed or neutral) and completed an eight-minute behavioural task.

Participants in the angry and anxiety groups were asked to think about an event that made them feel either emotion and were asked to talk about it for the duration of the task, while those in the depressed group were instructed to read scripts that became progressively sadder. Volunteers in the neutral condition were asked to count out loud for eight minutes.

Researchers compared changes in blood flow and blood vessel dilation and constriction before and after the eight-minute task using a blood pressure cuff, an intravenous catheter and sensors placed on the participant’s fingers.

Talking about a previous event that made you angry significantly reduced blood vessel dilation compared to the neutral group, and this impairment hung around for up to 40 minutes before returning to normal. Blood vessel dilation was similar between the anxiety, sadness and neutral groups.

The anger and anxiety tasks also elicited increases in blood pressure compared to the neutral task.

Professor Glenn Levine, a cardiologist who was not involved in the study, told JAMA Medical News the sympathetic nervous system could be responsible for the findings.

“We know in the short-term, episodes [of anger and stress] can increase adrenaline levels and sympathetic tone. Your heart rate goes up, your blood pressure goes up, your body releases adrenaline, and these can lead to increased oxygen demand by your heart. These can lead to constriction of your coronary arteries.”

Lead author Professor Daichi Shimbo poo-pooed Professor Levine’s theory, highlighting that while there was a similar increase in blood pressure seen in both the anxiety and anger conditions, impaired vasodilation was only seen when participants were instructed to see red.

Instead, Professor Shimbo felt the vasoconstrictor endothelin-1 – released when someone is stressed – was a more appropriate underlying mechanism, or that being angry could set off an inflammatory cascade that impacted vascular function.

Impaired vasodilation as a result of abnormal endothelial cell function could lead to a variety of processes that result in the buildup of atherosclerotic plaques, according to Professor Shimbo.

The Back Page agrees with Professor Shimbo’s concerns about the potential health risks for people who are always angry, given what they found when someone was only angry for eight minutes.

“I speculate if you’re a person who gets angry a lot, you’re chronically insulting your arteries. I think over time it’s going to reach a point that it’s going to be chronically dysfunctional. And that’s the step toward getting atherosclerosis and heart disease,” Professor Shimbo told JAMA Medical News.

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