Heart Attack Risk Increases After Angry Outbursts

Your heart doesn’t like you when you’re angry.

The risk of heart attack is 8.5 times higher in the 2 hours following bursts of intense anger, suggests research from the University of Sydney published in European Heart Journal: Acute Cardiovascular Care. The results confirm prior findings linking emotional triggers to severe cardiovascular episode risk.

“Our findings confirm what has been suggested in prior studies and anecdotal evidence, even in films—that episodes of intense anger can act as a trigger for a heart attack,” said Dr. Thomas Buckley of Sydney Nursing School, and the study’s lead author, in a press release. “The data shows that the higher risk of a heart attack isn’t necessarily just while you’re angry—it lasts for 2 hours after the outburst.”

Researchers used a 1 to 7 scale to gauge anger level, with a 5 or above qualifying as angry. Anger below a 5 on the scale was not associated with increased risk.

Anger triggers included arguments with family members, arguments with others, work anger, and driver anger.

Anxiety can also increase a patient’s heart attack risk, and was associated with a 9.5-fold increased risk of triggering a heart attack during the 2 hours following an episode of anxiety.

“Increased risk following intense anger or anxiety is most likely due to increase heart blood pressure, tightening of blood vessels, and increased clotting, all associated with triggering heart attacks,” Dr. Buckley said.

Researchers analyzed patients who were admitted to Royal North Shore Hospital with confirmed heart attacks, and interviewed them about their activities in the days before the episode and the frequency of various activities.

Although the absolute risk of emotionally triggered heart attacks is low, the danger remains present. As a result, the researchers recommend strategies to reduce stress, avoiding confrontation, and avoiding situations likely to trigger anxiety or angry outbursts, as well as traditional preventive measures.

“Improving general health by minimizing other risk factors, such as hypertension, high cholesterol, or smoking, would also lower risk,” said Professor Geoffrey Tofler of the Preventive Cardiology department at the University of Sydney. “For those at high risk, it is possible that medications such as beta-blockers and aspirin taken at the time of a trigger may interrupt the link between the stressor and the heart attack.”

The researchers are currently recruiting participants for a follow-up study to assess medication’s role in emotionally triggered heart attacks.

“Our research suggest that when managing a person with heart disease or in preventing heart disease in others, a person’s frequency of anger and anxiety should also be assessed and be part of helping individuals to take care of themselves,” Dr. Tofler said. “Our message to people is they need to be aware that a burst of severe anger or anxiety could lead to a coronary event, so consider preventative strategies where possible.”