Can being angry put you at risk of heart attack?

Angry outbursts are associated with an increased risk of heart attack, stroke and other cardiovascular problems, reports a novel study.

This link between extreme emotion and cardiovascular problems is greater if someone has preexisting risk factors, like a heart history, or if they are frequently angry, researchers found. Being angry alone as an independent factor poses little threat to one's heart health, they determined.

"For example, a person without many risk factors for cardiovascular 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," Dr. Elizabeth Mostofsky, an instructor at the Harvard School of Public Health, said in a statement.

Mostofsky and her colleagues calculated the risk for a cardiovascular issue after an angry outburst per every 10,000 people. Among people who had a low cardiovascular risk and who were angry only once a month, there was one extra heart attack (myocardial infarction [MI] or acute coronary syndrome [ACS]). For those who were angry frequently, the proportion increased to four people who also had high cardiovascular risk.

Overall, the findings showed that in the two hours immediately after an angry outburst, a person's risk of a heart attack (MI or ACS) increased almost five times (4.74 percent), the risk of stroke increased more than three times (3.62 percent), and the risk of ventricular arrhythmia increased compared to other times.

The authors stress that this research only proves an association between the two factors, and does not prove that angry outbursts cause heart problems, in part due to the inconsistency between different studies and the small, imprecise sample sizes used. Further research is needed, they note, to determine whether psychosocial intervention is needed to prevent cardiovascular events.

"Given the lessons we have learned from trying to treat depression after MI, treating anger in isolation is unlikely to be impactful. Instead, a broader and more comprehensive approach to treating acute and chronic mental stress, and its associated psychological stressors, is likely to be needed to heal a hostile heart," the authors concluded.

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