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A New Way Hotheads May Be Hurting Their Hearts

From the WebMD Archives

May 5, 2000 -- Hostility and anger may break your heart. Really.

Researchers from Ohio State University say these toxic emotions may be linked to the levels of a substance that many believe may increase the risk of heart attacks. The study findings suggest that hostility may trigger increases in blood levels of the substance called homocysteine. High levels of this substance are believed to increase the risk of heart disease.

When researcher Catherine M. Stoney, PhD, compared blood levels of homocysteine from persons who participated in a study measuring hostility and anger, she found that more hostile people had higher levels of homocysteine.

Moreover, she found that men who inhibit or suppress their anger have higher levels of homocysteine than men who release their anger. But she found no similar association among the women in the study, which is published in the April 28 issue of the journal Life Sciences.

Stoney and her colleagues measured hostility and anger in the 31 men and 33 women using standard psychological questionnaires. In the hostility questionnaire, "first we try to assess the kind of things that have to do with how one perceived the world and interacts with others," she says. For example, a question might ask if the person thinks other people are "just out to get what they can without regard for others."

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The anger questionnaire, she says, asks about ways in which a person reacts to certain situations. Stoney says, "for example, a scenario might be that one's boss is loud and critical. We ask how would you respond? Would you yell back? Would you just be quiet and hold in your anger?"

Stoney says earlier studies suggest that hostility and anger are related to increased activity in the nervous system during stress. "Therefore, one potential picture emerging from the current data is that men, particularly high hostile men, are demonstrating chronically elevated [nervous system] activity, resulting in higher homocysteine concentrations," she writes.

Asked to comment on the finding, Jonathan Abrams, MD, tells WebMD the study is "an interesting tidbit and probably deserves further evaluation." Abrams, a nationally known expert in preventive cardiology, will soon be publishing his own paper on homocysteine. He is a professor at the University of New Mexico School of Medicine.

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Abrams notes that this is a very small study that looked at patients with homocysteine levels in the normal ranges. He says, "We don't consider homocysteine elevated until it is in the range of 10 or 11 to 15. These levels are all well below that." In Stoney's study, the average homocysteine level for women was just under six and for men, who have higher homocysteine levels than women, it was about seven.

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Stoney says it is too early to suggest any practical purpose of the findings. Abrams says that it is likely that homocysteine is a risk factor for heart disease, but "we have no data that show that lowering homocysteine or modifying it will do anything."

Stoney agrees that no one knows whether lowering homocysteine may impact the risk of heart disease. Homocysteine is normally broken down in the body by B vitamins and the nutrient folic acid. But she says that most people could probably benefit by finding more flexible ways to express anger and by attempting to overcome hostility, perhaps through counseling.

Abrams says that theories that anger or personality type may contribute to heart disease have fallen into disfavor. "If you go to the heart meetings in recent years, you see that this is considered somewhat soft science and doesn't get much attention," Abrams says. "Although I believe that personality probably does play a role, it is just awfully hard to flesh out this theory."

Vital Information:

  • A new study shows that hostility and anger may cause a rise in levels of homocysteine in the blood, a substance that may increase the chance of having a heart attack.
  • Men who suppress their anger, instead of expressing it, have higher levels of homocysteine, but this did not hold true for women who inhibit their anger.
  • Scientists still have many questions about homocysteine, and do not yet know if lowering levels of the substance will consequently lower the risk of heart attack.
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