JAHA study: Brief anger may be bad for heart health, blood vessel function

Spending several minutes ruminating on a past situation that made you angry can interfere with your blood vessels’ ability to relax, thereby impeding blood flow, according to a study published in May in the Journal of the American Heart Association. 

“Impaired vascular function is linked to an increased risk of heart attack and stroke,” lead author Dr. Daichi Shimbo, a professor in the Division of Cardiology at Columbia University Irving Medical Center, said in a news release. “Observational studies have linked feelings of negative emotions with having a heart attack or other cardiovascular disease events. The most common negative emotion studied is anger, and there are fewer studies on anxiety and sadness, which have also been linked to heart attack risk.”

Shimbo and his colleagues explored the effects of anger, anxiety, and sadness on blood vessel function. The 280 people in the randomized controlled study were assigned one of these emotional tasks for eight minutes: 

• Anger: Recalling a personal memory that evoked anger
• Anxiety: Recalling a personal memory that evoked anxiety
• Sadness: Reading a series of depressing sentences
• Neutral: Repeatedly counting to 100

Prior to beginning their respective assignments, participants were instructed to relax for 30 minutes—in comfortable chairs in a temperature-controlled room—without talking or using their phones. They also weren’t allowed to read or sleep. Next, researchers collected blood samples and measured participants’ heart rate, blood pressure, and blood vessel dilation. Finger probes helped assess arterial blood flow.

Immediately after the emotional task, researchers examined the cells lining participants’ blood vessels, keeping an eye out for increased cell injury, impaired blood vessel dilation, and reduced cell repair capacity. The team repeated these assessments after three, 40, 70, and 100 minutes.

Negative emotions not tied to heart disease risk the same way

People in the anger group showed impaired blood vessel dilation up to 40 minutes after recalling a time they were enraged. Previous research shows such impairment may increase risk of atherosclerosis—a condition where plaque builds up in the arteries, heightening chances of stroke and heart disease. In this study, though, the damage was no longer detected after 40 minutes.

“We saw that evoking an angered state led to blood vessel dysfunction, though we don’t yet understand what may cause these changes,” Shimbo said. “Investigation into the underlying links between anger and blood vessel dysfunction may help identify effective intervention targets for people at increased risk of cardiovascular events.”

People in the anxiety and sadness groups didn’t demonstrate any statistically significant changes in their blood vessel linings. Shimbo and his team stressed that future research shouldn’t group negative emotions together in their associations with higher heart disease risk.

All participants were adults residing in the New York City area, with an average age of 26. They self-identified as 50% female, 40% white, 29% Hispanic/Latino, 19% Asian, and 14% Black. All were “healthy,” here meaning free of certain medical conditions including stroke, heart disease, high blood pressure, Type 2 diabetes, and mental illness. They were also nonsmokers who weren’t taking any prescription medications or dietary supplements. 

Because of these factors, it’s “unclear whether the results would apply to older adults with other health conditions, who would most likely be taking medications,” Shimbo said. Another limitation is the study was conducted in a controlled health care environment, as opposed to a real-world setting. Future research may study longer-term effects of anger, anxiety, sadness, and other negative emotions.

The National Heart, Lung, and Blood Institute (NHLBI) funded the study. Its findings fill a longstanding knowledge gap in how anger negatively impacts the heart, NHLBI psychologist Laurie Friedman Donze, PhD, said in another news release.

“It also opens the door to promoting anger management interventions as a way to potentially help stave off heart disease, the leading cause of death in this country,” Donze said.

Tips to manage your anger

If you’re aware your anger is frequent, severe, and negatively impacting your relationships and quality of life, a licensed mental health care provider can help you get back on the right track. In addition, the American Psychological Association recommends these and other anger management tips:

• Relax: Calming activities such as deep breathing, visualization exercises, and yoga-like movements can defuse tense moments.
• Change your environment: Your immediate surroundings can weigh down or irritate you. Be sure to schedule some quiet time to yourself in a relaxing atmosphere.
• Use humor: A good laugh can often take the edge off.
• Communicate better: If you’re in an argument, slow down and think before you speak. Don’t forget to actively listen to what others are saying.

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