Don't hurt your heart

Learn to manage your anger to avoid coronary disease, says Sujata Mukherjee

Do you have fits of rage so explosive that not only do you scream at others but also throw things? If you are fit to burst when you lose your temper, here's some bad news: your anger could cost you your life, recent research has found.

Fits of explosive rage put a person at greater risk of coronary heart disease, which refers to a narrowing of the coronary arteries - the blood vessels that supply oxygen to the heart muscles - due to a deposition of fat or plaque on the artery walls. It is also known as coronary artery disease or CAD. A huge study published in the Journal of the American College of Cardiology has found that anger and hostility are significantly associated with not only a higher risk for coronary heart disease in healthy individuals but also a poorer condition in patients with the disease.

Incidentally, angry men without a diagnosis of CAD are more likely to suffer a coronary malfunction than women. This suggests that the accumulation of daily stress has a greater impact on future heart disease in men.

Earlier, an extensive study in the journal Circulation in 2000 had found that those who tended to have frequent fits of rage - but normal blood pressure - were also vulnerable to CAD or heart attack. Among the 12,986 middle-aged men and women studied, those who were the most bad-tempered faced roughly twice the risk of CAD and about three times the risk of a heart attack compared to those with the least anger issues.

Managing anger may be an important adjuvant strategy in preventing CAD in healthy individuals and treating patients suffering from the disease, the recent study concludes. While it is unhealthy to bottle up rage, going to the other extreme and exploding with it is downright dangerous. Of course, you have a right to be angry - and show it - but make that the exception rather than the rule.

Experts point out that frequent fits of anger affect the heart and arteries. "The moment you get angry, it triggers a flight-and-fight response [a primitive reaction to an acute threat to survival that prepares a human or animal to react or retreat]. This opens the floodgates of a lot of stress hormones or neurochemicals, resulting in an increase in heart rate and blood pressure," says cardiologist Suvro Banerjee. "These eventually constrict the coronary artery. If, by chance, there are fatty deposits or plaques on the artery wall, it can rupture and lead to a heart attack." Excessive stress also disrupts the heart's electrical impulse, resulting in a disturbance of heart rhythms, which can lead to sudden death.

When stress hormones shoot up, it also leads to the rise of C-reactive protein (CRP) in the blood - a marker for inflammation in the body. CRP is produced in the liver and its levels can be used to evaluate your risk of developing coronary artery disease, which can lead to a heart attack. A 2004 study by scientists of Duke University in the US - published in the journal, Psychosomatic Medicine - found that those who tended to get enraged, tense and hostile easily have double or even triple the normal level of CRP in their blood.

Anger has not only a biological effect but also a psychological one. "Frequent fits of anger can make you lonesome. This further leads to stress, tension and sadness, followed by intense depression," says Calcutta-based neuropsychiatrist Amitabha Mukerji. "All these damage your heart to a large extent. One must control such rage at any cost," he adds.

"Those who have too much negative emotion also tend to have irregular habits and defy doctor's advice," says Banerjee. "They tend to smoke, drink, fall prey to substance abuse, have an unhealthy diet and a sedentary lifestyle, which often leads to higher blood pressure, diabetes and cholesterol, making them vulnerable to heart attacks. I have come across many cases in which people have suffered a severe heart attack in the heat of the moment," the cardiologist warns.

Do not add to that list; make sure you moderate your expressions of anger and stay heart healthy.

Temper your anger 

• Recognise that your anger is over the top; you are often furious over trivial issues

• Try to understand what makes you angry and pre-empt the situation

• Don't react to a situation. Just listen and keep your cool

• If you fail to rein in rage, don't be impatient. Anger fades away on its own. Be patient, keep your mouth shut. If possible, move away from the spot. Take a brisk walk or do something to divert yourself

• Anger is default option for many; such people should learn to consciously turn it off. Another way to control anger is to visualise a relaxing experience. You can learn these two techniques from a trained therapist

• Deep breathing, yoga and meditation help control rage. Even if you get angry, you can get the better of it

• When all else fails, try behavioural therapy. It can work wonders

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