University of Sydney research reveals that the risk
of a heart attack is 8.5 times higher in the two
hours following a burst of intense anger and 9.5
fold with high levels of anxiety.
Published in European Heart Journal Acute
Cardiovascular Care, this is the first Australian
study to investigate the link between acute
emotional triggers and high risk of severe cardiac
episodes.
"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 lead author Dr
Thomas Buckley, Sydney Nursing School, University of
Sydney, and researcher at Royal North Shore
Hospital.
"The data shows that the higher risk of a heart
attack isn't necessarily just while you're angry -
it lasts for two hours after the outburst.
In the study, 'anger' was qualified as 5 and above
on a 1-7 scale, referring to 'very angry, body tense,
clenching fists or teeth, ready to burst', up to 'enraged,
out of control, throwing objects'. Anger below this
level was not associated with increased risk.
"The triggers for these burst of intense anger were
associated with arguments with family members (29
per cent), argument with others (42 per cent), work
anger (14 per cent) and driving anger (14 per
cent)," said Dr Buckley.
"The data also revealed that episodes of anxiety can
also make you more likely to have heart attack.
"High levels of anxiety were associated with a 9.5
fold increased risk of triggering a heart attack in
the two hours after the anxiety episode.
"Increased risk following intense anger or anxiety
is most likely due to increased heart rate, blood
pressure, tightening of blood vessels and increased
clotting, all associated with triggering heart
attacks," he said.
The study was an investigation of consecutive
patients suspected of heart attack and confirmed by
angiography reports at Royal North Shore hospital.
Patients confirmed with acute coronary blockage were
admitted, interviewed about their activities in the
48 hours before the onset of symptoms, and usual
frequencies of activities were recorded for
comparison.
"Although the incidence of anger-triggered heart
attacks is around 2%, of the sample, those people
were 8.5 times more likely to have a heart attack
within two hours of the emotional episode. So while
the absolute risk of any one episode triggering a
heart attack is low, this data demonstrates that the
danger is very present.
"Our findings highlight the need to consider
strategies to protect individuals most at risk
during times of acute anger.
Senior author Professor Geoffrey Tofler, Preventive
Cardiology, University of Sydney said "Potential
preventive approaches may be stress reduction
training to reduce the frequency and intensity of
episodes of anger, or avoiding activities that
usually prompt such intense reactions, for instance,
avoiding an angry confrontation or activity that
provokes intense anxiety.
"Additionally, improving general health by
minimising other risk factors, such as hypertension,
high cholesterol or smoking would also lower risk.
"For those at high risk, it is possible that
medication such as beta-blockers and aspirin taken
at the time of a trigger may interrupt the link
between the stressor and the heart attack. We are
currently recruiting subjects for a study examining
this option.
"Our research suggests 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.
"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," Dr Tofler said.
For more information
European Heart journal - Acute Cardiovascular Care
Study: Triggering of acute coronary occlusion by
episodes of anger
The
University of Sydney
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