How Anger Hurts Your Heart

Chill pills are good 4 u

Yellers, ragers, and door slammers beware -- frequent high levels of anger have now been linked to heart disease.
By Katherine Kam

If you knew that frequent anger might raise your risk of heart disease significantly, would you continue to blow off steam by yelling and smashing things during an argument or getting furious if the office email crashes during a rushed, stressful day?

It's time for hot heads to take heed: Increasingly, the negative, irritable, raging, and intimidating personality type worries heart researchers and doctors alike. "You're talking about people who seem to experience high levels of anger very frequently," says Laura Kubzansky, PhD, MPH, an associate professor at the Harvard School of Public Health in Cambridge, Mass., who has studied the role of stress and emotions on cardiovascular disease.

The key here is "high" levels. Moderate anger may not be the problem, according to Kubzansky. In fact, expressing 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 hurl objects or scream at others may be at greater risk for heart disease, as well as those who harbor suppressed rage, she says. "Either end of the continuum is problematic."

Anger's Physiological Effects on the Heart
So how exactly does anger contribute to heart disease? Scientists don't know for sure, but anger might produce direct physiological effects on the heart and arteries. Emotions such as anger and hostility quickly activate the "fight or flight response," in which stress hormones, including adrenaline and cortisol, speed up your heart rate and breathing and give you a burst of energy. Blood pressure also rises as your blood vessels constrict.

While this stress response mobilizes you for emergencies, it might cause harm if activated repeatedly. "You get high cortisol and high adrenaline levels and that is the cardiotoxic effect of anger expression," says Jerry Kiffer, MA, a heart-brain researcher at the Cleveland Clinic's Psychological Testing Center. "It causes wear and tear on the heart and cardiovascular system." Frequent anger may speed up the process of atherosclerosis, in which fatty plaques build up in arteries, Kiffer says. The heart pumps harder, blood vessels constrict, blood pressure surges, and there are higher levels of glucose in the blood and more fat globules in the blood vessels. All this, scientists believe, can cause damage to artery walls.

And anger might not be the only culprit. In Kubzansky's own research, she found that high levels of anxiety and depression may contribute to heart disease risk, too. "They tend to co-occur," she says. "People who are angry a lot tend to have other chronic negative emotions as well."

Emotions and the Heart
According to an analysis of findings from 44 studies published last year in the Journal of the American College of Cardiology, evidence supports the link between emotions and heart disease. To be specific, anger and hostility are significantly associated with more heart problems in initially healthy people, as well as a worse outcome for patients already diagnosed with heart disease.

Emotions and the Heart continued...
The same study also showed that chronically angry or hostile adults with no history of heart trouble might be 19% more likely than their more placid peers to develop heart disease. The researchers found that anger and hostility seemed to do more harm to men's hearts than women's. Among patients already diagnosed with heart disease, those with angry or hostile temperaments were 24% more likely than other heart patients to have a poor prognosis.

In light of such findings, some doctors now consider anger a heart disease risk factor that can be modified, just as people can lower their cholesterol or blood pressure. "We're really good at treating heart attacks, but we're not that good at preventing them," says Holly S. Andersen, MD, cardiologist and director of education and outreach at the Ronald O. Perelman Heart Institute at New York-Presbyterian Hospital/Weill Cornell Medical Center. "Stress is not as easy to measure as your cholesterol level or your blood pressure, which are clearly objective. But it's really important that physicians start taking care of the whole person -- including their moods and their lives -- because it matters." The bottom line: "A change of mind can lead to a change of heart," Kiffer says.

Coping With Anger
Got a hair-trigger temper? Counseling and anger management might help in the long term, but what can you do for a quick fix?

Recognizing signs that you're getting angry and shifting your frame of mind will help, says Wayne Sotile, PhD, author of Thriving With Heart Disease. The next time you feel your anger -- and heart rate -- rising, try these coping statements to get a grip fast:

"I can't accomplish anything by blaming other people, even if they are responsible for the problem. I'll try another angle."
"Will this matter five years from now? (Five hours? Five minutes?)"
"If I'm still angry about this tomorrow, I'll deal with it then. But for now, I'm just going to cool off."
"Acting angry is not the same as showing that I care."