Anger is neither good nor bad. It is simply a human emotion. However, increasing evidence links anger to cardiovascular disease. Various studies have shown that anger may aggravate coronary artery disease and raise blood pressure. Chronic anger (called trait anger by medical specialists) contributes to long-term heart problems, and acute episodes of anger (i.e., a single outburst) have been linked to a slightly increased incidence of heart attack.
Though the relative risk of anger to your heart is small, there are strategies that can help people deal with their anger in a healthier way. It appears that the calm, direct expression of anger defuses many of its unhealthy characteristics.
Learning to deal with anger not only reduces the risk of heart disease, but it may help reduce the incidence of child abuse, domestic violence, road rage and other societal problems that are connected to rage.
About anger
Anger is a physical and emotional phenomenon. During episodes of anger, people frequently clench their fists, yell, and their faces may become flushed with blood. These physical manifestations of anger affect systems throughout the body. Stress chemicals such as adrenaline are released, and the heart rate and blood pressure are raised. At the same time, the arteries supplying oxygen-rich blood to the heart narrow, and the blood is “stickier,” raising the risk of blood clots.
Acute episodes of anger have been linked to heart attack and to abnormal heart rhythms called arrhythmias. Recent studies have also shown that anger can contribute to risk factors for heart disease (e.g., higher homocysteine and cholesterol levels) and even trigger sudden cardiac death.
Not all people experience anger in the same way. Some personality types seem prone to anger, whereas others are more relaxed and calm. Some people bottle their anger up, refusing to express it, though still others freely and loudly vent their anger given the slightest provocation.
Expressing anger in a healthy way may contribute to an overall healthy lifestyle. Chronic anger or hostility has been linked to unhealthy lifestyle habits, such as cigarette smoking, alcohol abuse and poor diet. Learning anger management techniques could help reduce the stress on your cardiovascular system and ultimately save your life.
Anger and heart attacks or heart disease
Studies show that the healthiest way of dealing with anger appears to be expressing it calmly, rather than exploding or attempting to conceal it. People who are more likely to “blow up” over minor inconveniences, or who feel angry almost all the time, appear to be at greater risk of heart disease and/or heart attacks. Research has demonstrated a clear link between anger and cardiovascular health.
A groundbreaking study completed in 2004 found that anger and frustration can provoke abnormal heart rhythms (arrhythmia), which can lead to sudden cardiac death. Scientists discovered that mental stress caused arrhythmia more quickly than physical stress (e.g., exercising) in people with an implantable cardioverter defibrillator. This study was the first to show that mental stress alone can trigger arrhythmia, and researchers hope future studies will help identify personalities at higher risk for developing abnormal cardiac rhythms.
There have also been cases where anger has resulted in a severe coronary artery spasm that is capable of causing changes similar to a heart attack or leading to severe permanent heart damage. In some cases these damages may be reversible with time.
Anger plays a strong role in the development of heart disease. One study found that men who bottled up their anger had a 75 percent higher chance of developing coronary artery disease than men who vented or talked through their anger. Anger was also linked to high blood pressure and high levels of calcification, two risk factors for heart disease.
Men with the most intense levels of anger have three times greater risk of a heart attack and/or a type of chest pain called angina than men with the least intense anger levels, according to some studies. The risk seems to be especially high for men who become angry enough to want to break things or to physically strike out at someone.
Other studies suggest that even lower levels of negative behavior can impact heart health. For instance, a study found a significantly higher risk of heart disease for people with impatient, irritable and/or dominant personalities (shown by interrupting other people, for example) as compared to more patient personalities.
The damaging effects of anger may accumulate over time. A 2002 study found that heart attacks appear to increase in those who respond to stress with high levels of anger, either expressed or concealed. The study was notable because it focused on young men and followed them for 48 years.
Anger and blood pressure
There are many physical changes that accompany anger, including increased heart rate and blood pressure. Though these changes are usually temporary, prolonged or frequent periods of anger could, over time, contribute to the development of high blood pressure.
Research has found that people who are generally more hostile seem to experience more intense anger than less hostile people. Also, those more hostile people appear to hang on to their anger for longer periods of time. This corresponds to a higher and longer rise in blood pressure while angry for people prone to hostility.
Anger and stroke
Like the research on anger and heart disease, research on anger and strokes suggests that direct and calm expressions of anger may be healthier than chronic anger/hostility or pent-up, unexpressed rage. Some studies, for instance, found that middle-aged men were significantly more likely to suffer a stroke, and that older women with hostile attitudes (expressed or unexpressed) were more likely to develop carotid artery disease. Carotid artery disease significantly increases the risk for stroke.
Tips for controlling anger
Learning anger management techniques can help you reduce stress on your cardiovascular system. Tips for effectively controlling anger include:
Use relaxation techniques. Relaxation techniques, such as meditation exercises and breathing exercises, can be used to calm anger during tense situations.
Other healthy strategies for relaxation include:
Exercising
Writing in a journal or diary
Confiding in, or “venting” to, a friend
Listening to relaxing music or an inspirational tape
Communicate better. Do not speak the first thing that comes to your mind when you are angry. Instead, think carefully before speaking. Also, try to remain open to what the other person is saying.
Remain positive. The situations that trigger anger are often temporary, so try to keep a balanced perspective. It is also important to remember that giving into anger will not improve the situation.
Avoid people or situations that trigger anger. For instance, people who frequently experience “road rage” during their commute to work may benefit from finding a less congested route or taking mass transit. In addition, try to avoid people that frequently cause you to experience feelings of anger.
Questions for your doctor
Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to anger:
How can I tell if I get too angry too often?
Could anger affect my blood pressure?
What type of cardiovascular symptoms could frequent bouts of anger result in?
Where can I find help with better controlling my anger?
Are there any medications available that might make it easier for me to control my anger?
Are there any therapies or techniques I can use to better control my anger?
Could anger aggravate any of my existing conditions?
Could my anger affect the health of those around me in any way?
Could anger interfere with my pregnancy in any way? Could it affect my unborn child?
