The Telegraph
Wednesday , March 5 , 2014
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Lost temper? Watch your heart for two hours

New Delhi, March 4: In the election season of name-calling, finger-pointing and mud-slinging, make sure to keep an eye on yourself for two hours after the worst bouts of anger.

Outbursts of anger appear to trigger heart attacks, strokes or severely abnormal heart rhythms within two hours, according to the first systematic review of previous research exploring links between emotions and serious cardiovascular events.

The review by researchers in the US also suggests that the impact of anger outbursts will be higher among people with underlying risk factors such as high blood pressure, smoking or diabetes than among people without these.

“We find consistent evidence of a higher risk of cardiovascular events in the two hours after outbursts of anger,” Elizabeth Mostofsky, an epidemiologist at the Harvard School of Public Health, and a member of the research team told The Telegraph.

While earlier studies have investigated the associations between anger and single cardiovascular outcomes such as heart attacks, strokes or irregular heart rhythms, Mostofsky said, some of these studies involved small samples of patients and the results were reported with “low precision”.

Mostofsky and her colleagues scanned hundreds of medical studies conducted between 1966 and 2013 and selected nine relevant ones that included over 6,000 patients with cardiovascular events. Their analysis, published yesterday in the European Heart Journal, has shown that all of the previous studies reported a higher risk of cardiovascular events whether it was a study of heart attacks, strokes or irregular heart rhythms.

The researchers point out that earlier studies have shown that psychological stress can increase the heart rate and blood pressure and that such mechanisms may serve as a “common pathway” for events such as heart attacks, strokes or irregular heart rhythms.

Their analysis suggests that the more the anger episodes, the higher the risk of cardiovascular events. One extra heart attack could be expected per 10,000 people per year with low cardiovascular risk who get angry only once a month, but this rises to four per 10,000 people with a high cardiovascular risk.

It also suggests that five episodes of anger per day would result in 158 extra heart attacks per 10,000 people per year among people with a low cardiovascular risk, but this rises to 657 extra heart attacks among people at high risk of cardiovascular disease, according to a media release from the journal.

“A key research goal for the future would be to identify methods to break this link between anger outbursts and the risk of cardiovascular events — either through psychosocial counselling or drug treatment,” Mostofsky said.

Cardiologists not associated with the analysis say that while the findings by the Harvard team are not surprising, they may stir medical professionals into specifically focussing on the anger component of stress, a risk factor for cardiovascular events.

“We routinely tell patients at risk of cardiovascular events to avoid stress,” Sandeep Seth, additional professor of cardiology at the All India Institute of Medical Sciences, New Delhi, said. “But anger is easier to control than other components of stress that may be beyond a patient’s control.”

Murray Mittleman, director of the cardiovascular epidemiology research unit at Harvard Medical School who led the analysis, said in the journal media release that doctors could ask patients about their usual levels of anger and — if they find that it is relatively high — prescribe either psychosocial or drug therapy.