Angry outbursts raise risk for heart attack, stroke

Getting really mad may be really bad for people who are at high risk for cardiovascular events like heart attack and stroke.

According to a study in the European Heart Journal, a person’s risk for having such a serious event appears to increase significantly in the two hours immediately after an angry outburst. That risk is highest in people who already have other risk factors for cardiovascular disease and who lose their temper often, researchers found.

“A person without many risk factors for cardiovascular disease who has only one episode of anger per month has a very small additional risk,” said study co-author Elizabeth Mostofsky, MPh, ScD. “But a person with multiple risk factors or a history of heart attack or stroke, and who is frequently angry, has a much higher absolute excess risk accumulated over time.”

About the study

The study was based on nine previously completed studies that looked at angry outbursts among thousands of people who had strokes, heart attacks and other cardiovascular problems. Those studies were done between 2002 and 2013 in the U.S. and several other countries.

In eight of the studies, investigators who did the original research used a specific assessment tool to measure the participants’ anger, although how they administered the tool and interpreted its results varied. In the ninth study, participants recorded their anger in a diary.

The researchers found:

  • The risk of a heart attack or other serious heart event was 4.74 times higher in the two hours after an angry outburst, compared to times when the person was not angry.
  • The risk of stroke caused by a blood clot was 3.62 times higher during those two hours, compared to times without anger.
  • The risk for abnormal heart rhythms increased as well. One study found that the risk for ventricular tachycardia (a fast heart rate starting in the lower chambers of the heart) or ventricular fibrillation (a chaotic heartbeat) was 3.2 times higher in the hour following moderate anger. That jumped to nearly 17 times higher in the hour after intense anger, compared to times without anger.
  • The more often someone was angry, the greater the risk. A single angry outburst once a month in someone at low risk for heart disease was associated with just one additional cardiovascular event per every 10,000 people each year. But among low-risk people who had at least five angry outbursts per day, there were 158 additional events.
  • The higher someone’s risk of a serious event, the greater the potential impact of their anger. While there were 158 additional events among low-risk people who were angry at least five times each day, there were 657 additional events among high-risk people who showed similar anger.

The researchers noted that their results don’t prove that angry outbursts caused the heart attacks, strokes or other events among the people in the various studies. They also emphasized that the differing methods of the nine studies make it difficult to be certain of the current findings.

Even so, evidence from all of the studies pointed consistently to a link between anger and cardiovascular events, the authors concluded.

Why would anger raise the risk of these kinds of events? The authors noted that psychological stress has been shown to increase heart rate and blood pressure and to cause constriction of blood vessels. This could cause plaque in arteries to break up and form dangerous clots, they theorized.

The take-home message
If you frequently get angry, you may be at increased risk for a heart attack or stroke—particularly if you have high blood pressure, high cholesterol or other conditions that make you vulnerable to heart and vascular disease.

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