Anger ups the risk of heart attack eightfold

An episode of intense anger could lead to an eight-fold increase in the risk of heart attack, a new study has warned.
The risk of heart attack has been found to be 8.5 times higher in the two hours following an acute episode of anger than during the "usual frequency" patterns of anger.
The findings emerged from a well controlled study in which acute coronary blockage was angiographically confirmed in patients hospitalised for suspected heart attack.
This elevated state of anger or anxiety preceding the myocardial infarction (MI, heart attack) was also found to be significantly higher than at the same time the preceding day.

The study was an investigation of patients suspected of MI and admitted for primary angioplasty at the Royal North Shore Hospital in Sydney, Australia, between 2006 and 2012, and assessed by coronary angiography.
Of 687 patients initially assessed, 313 were confirmed with occluded coronary blood flow by angiography and were enrolled in the study.

Anger, as evident over the 48 hours preceding the onset of symptoms, was self-assessed by questionnaire according to a seven-point scale, with 1 defined as "calm", and 7 as "enraged, out of control, throwing objects, hurting yourself or others".
For study purposes, the threshold of acute anger was defined by level 5 - "very angry, body tense, maybe fists clenched, ready to burst".

Analysis of responses showed that seven of the 313 confirmed MI cases (2.2 per cent) had reached anger of at least level 5 within the two-hour preceding the onset of symptoms.
In addition, one participant had reached anger level 5 within four hours of the MI, and anger level 4 ("moderately angry, so hassled it shows in your voice") was reported by two participants within two hours of MI and by three participants within four hours.
Based on the subjects' usual frequency for anger, the relative risk of onset of MI symptoms occurring within two hours of reaching anger level 5 or above was calculated as 8.5), an eight-fold greater level of risk than that associated with normal levels.

"While the absolute risk of any one anger episode triggering a heart attack is low, our data demonstrates that the danger is real and still there," Dr Thomas Buckley, researcher from the University of Sydney and Royal North Shore Hospital, Sydney, said.
Statistical associations with lower levels of anger, or anger occurring over two hours before symptom onset did not reach statistical significance.
However, high levels of anxiety were associated with a 9.5-fold increased risk of triggering MI in the two hours after the anxiety episode when compared with anxiety levels the previous day.
The study was published in the European Heart Journal: Acute Cardiovascular Care.