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Heart Attack Risk Rises in Hours After Angry Outburst: Study

Absolute risk from any one episode remains very small, but the danger is there, experts say

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But certain people might be at higher risk, Mostofsky added.

"Although the risk of experiencing an acute [heart] event with any single outburst of anger is relatively low, the risk can accumulate for people with frequent episodes of anger," she said in a journal news release. "This is particularly important for people who have higher risk due to other underlying risk factors or those who have already had a heart attack, stroke or diabetes."

"For example, a person without many risk factors for [heart] disease who has only one episode of anger per month has a very small additional risk, 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," she said.

Among people with low heart risk who got angry only once a month, angry outbursts could result in one extra heart attack per 10,000 people per year, the researchers said. That increased to an extra four heart attacks among those with a high heart risk.

Among people who got angry more often, five bouts of anger a day would lead to approximately 158 extra heart attacks per 10,000 people per year among those with low heart risk, and 657 extra heart attacks among those with high heart risk.

The findings do not necessarily show that anger causes heart attacks and other heart events, only that there is an association between them, the researchers said. They added, however, that the findings were fairly consistent across all of the studies included in the review.

"Cardiologists have long known about the adverse effects of depression after a heart attack but this article emphasizes the need to not only screen for depression but also screen for other components of mental stress," Bangalore said.

Another expert agreed.

"In managing a patient with [heart] disease, it is important to ascertain if the patient is quick to react when it comes to the anger response, as this personality trait may increase the risk of heart attacks and be worth treating," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City.

"Whether it be a behavioral intervention or medication, as physicians, we need to ask the patient about anger, as they can increase the risk of heart attacks and may need to be a part of how we council our patients to take care of themselves," she added.

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