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Anger Linked to Heart Disease

Anger, Hostility, and Depression Tied to Inflammation, Heart Disease Risk

WebMD Health News

Sept. 22, 2004 -- A bad attitude may put your heart at risk, regardless of how well you've got the other traditional heart disease risk factors under control, according to a new study.

Researchers found otherwise healthy people prone to anger, hostility, and depression have higher levels of a substance linked to narrowing of the arteries and future heart disease risk called C-reactive protein (CRP). This protein is released in the body in response to the inflammation caused by stress, infection, and other threats to the immune system.

Depression and anger have long been linked to a higher risk of heart disease, but experts say this is one of the first studies to provide proof of a possible mechanism behind the relationship.

Researchers say the findings show that these behavioral and psychological factors might help account for the 50% of heart attacks that occur among people without any of the traditional risk factors for heart disease.

"These psychological behaviors do have implications in determining health or the risk of disease that we have," says researcher Edward Suarez, PhD, associate professor of psychiatry and behavioral sciences at Duke University Medical Center.

"This is the first study to show there is an independent association between depression and C-reactive protein," Suarez tells WebMD, "regardless of their weight, blood pressure, [cholesterol] levels, alcohol use, and exercise status."

C-Reactive Protein Tied to Depression

In the study, published in the September issue of Psychosomatic Medicine, 127 healthy men and women completed personality questionnaires that assessed anger, hostility, and depressive symptoms. Blood tests were then performed to measure CRP levels.

None of the participants had any history of heart disease or other risk factors associated with heart disease and high CRP levels, such as smoking, high blood pressure, diabetes, and obesity.

The study showed that healthy adults who had mild to moderate symptoms of depression, anger, or hostility had levels of CRP, a marker of inflammation in the blood, that were two to three times higher than those of their calmer counterparts. And the more negative their moods, the higher their CRP levels were.

Suarez says that it's the clustering of anger, hostility, and depression that commonly occurs in the same individual that may produce the greatest risk. For example, people with these attributes may evaluate their surroundings in a cynically hostile way and then react with anger to events, which is then commonly accompanied by mild to moderate symptoms of depression.

Suarez explains that it may be that people prone to anger go through life and consistently react negatively to life events. In response, their bodies release stress hormones that eventually lead to an elevation in CRP.

These CRP elevations do not fluctuate as easily as hormones and are instead maintained for long periods of time, which may subsequently increase the risk of narrowing of the arteries and heart disease.

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