Anger, heavy exertion may trigger heart attack: study

Being angry, emotionally upset or engaging in heavy physical exertion may trigger a heart attack, according to new research.
Researchers have found an association (more than twice the risk) between anger or emotional upset and the onset of heart attack symptoms within one hour.
The same was true for heavy physical exertion during the hour before their first heart attack.
However, the association was stronger (more than triple the risk) in those patients who recalled being angry or emotionally upset while also engaging in heavy physical exertion.
"Previous studies have explored these heart attack triggers; however, they had fewer participants or were completed in one country, and data are limited from many parts of the world," said lead author Andrew Smyth, researcher at the Population Health Research Institute at McMaster University in Canada.

"This is the first study to represent so many regions of the world, including the majority of the world's major ethnic groups," said Smyth.

Researchers analysed data from 12,461 patients (average age 58) with first-ever heart attacks across 52 countries.
Participants completed a questionnaire about whether they experienced any of the triggers in the hour before their heart attack. They were also asked if they had experienced any of the triggers in the same one hour period on the day before their heart attack.
Researchers said that these triggers appeared to independently increase a person's heart attack risk beyond that posed by other risk factors, including age, smoking, obesity, high blood pressure and other health problems.

Smyth said that extreme emotional and physical triggers are thought to have similar effects on the body.
"Both can raise blood pressure and heart rate, changing the flow of blood through blood vessels and reducing blood supply to the heart," he said.
"This is particularly important in blood vessels already narrowed by plaque, which could block the flow of blood leading to a heart attack," he added.
"Regular physical activity has many health benefits, including the prevention of heart disease, so we want that to continue," he said.
"However, we would recommend that a person who is angry or upset who wants to exercise to blow off steam not go beyond their normal routine to extremes of activity," he said.

The study appears in the American Heart Association's journal Circulation.