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Rein In the Rage: Anger and Heart Disease

Experts explore the connection between anger and heart disease, and give tips for getting your anger under control.
By
WebMD Feature
Reviewed by Robert J Bryg, MD

If a caller upsets you, do you hurl the phone across the room? Do you curse and blast the horn furiously if the driver in front of you takes three seconds to notice the green light? An angry temperament can hurt more than relationships -- anger and heart disease may go hand in hand, according to experts.

"You're talking about people who seem to experience high levels of anger very frequently," says Laura Kubzansky, PhD, MPH, an assistant professor at the Harvard School of Public Health who has studied the role of stress and emotion on cardiovascular disease.

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Moderate anger may not be the problem, she says. In fact, expressing one's anger in reasonable ways can be healthy. "Being able to tell people that you're angry can be extremely functional," she says.

But explosive people who throw things or scream at others may be at greater risk, as well as those who harbor suppressed rage, she says. "Either end of the continuum is problematic."

Gender doesn't appear to make much difference, she adds. "Once people are chronically angry, men and women seem to be at equally high risk."

Scientists don't all agree that anger plays a role in heart disease, she says. But many studies have suggested a significant link. "I think the case is strong," Kubzansky says.

For example, one large study published in Circulation in 2000 found that among 12,986 middle-aged African-American and white men and women, those who rated high in traits such as anger -- but had normal blood pressure -- were more prone to coronary artery disease (CAD) or heart attack. In fact, the angriest people faced roughly twice the risk of CAD and almost three times the risk of heart attack compared to subjects with the lowest levels of anger.

Anger may not be the only culprit in heart disease risk. Kubzansky's own research suggests that other extreme, negative emotions may contribute, too. "Anger is a problem, but so, too, are high levels of anxiety and depression. They tend to co-occur. People who are angry a lot also tend to have other chronic negative emotions as well.

Anger and Heart Disease: What's the Connection?

How might hotheads be hurting their hearts?

Scientists speculate that anger may produce direct biological effects on the heart and arteries. Negative emotions, such as anger, quickly activate the "fight-or-flight response." They also trigger the "stress axis," Kubzansky says. "That's a slightly slower response, but it activates a cascade of neurochemicals that are all geared toward helping you in the short run if you're facing a crisis."

While these stress responses mobilize us for emergencies, they might cause harm if repeatedly activated. "When they persist over time, they end up being potentially damaging," she says.

For example, excessive amounts of stress hormones may speed up the process of atherosclerosis, in which fatty plaques build up in arteries, Kubzansky says.

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