Bottling up emotions is thought to harm both mind and body, but a new study suggests that doing the opposite may be no better.
In a study of nearly 4,000 heart attack patients, those who recalled having flown into a rage during the previous year were more than twice as likely to have had their heart attack within two hours of that episode, compared to other times during the year.
“There is transiently higher risk of having a heart attack following an outburst of anger,” said study author Elizabeth Mostofsky, a postdoctoral fellow with the Cardiovascular Epidemiology Research Unit at Harvard Medical School.
The greater the fury — including throwing objects and threatening others — the higher the risk, Mostofsky’s team reported in the American Journal of Cardiology.
The data came from patients who were part of a study between 1989 and 1996 to determine what brought on their heart attacks.
Within four days of having a myocardial infarction — the classic heart attack — participants were asked about a range of events in the preceding year and about their diet, lifestyle, exercise habits and medication use.
Almost 1,500 participants reported having had outbursts of anger in the previous year; 110 of them had those episodes within two hours of the onset of their heart attacks.
Participants recalled their anger on a seven-point scale that ranged from irritation to a rage that caused them to lose control.
The researchers found that with each increment of anger intensity, the risk of heart attack in the next two hours rose, and it was greatest after the person’s emotional reaction was “enraged! lost control, throwing objects, hurting yourself or others.”
The most frequent causes of anger outbursts that participants recalled were family issues, conflicts at work and commuting.
Although the research cannot prove that the angry outbursts led to the heart attacks, the results “make sense,” according to James O’Keefe Jr., a cardiologist at St. Luke’s Hospital in Kansas City, Mo., who wasn’t involved in the research.
Anger releases the fight-or-flight-response chemicals epinephrine and norepinephrine, he said. Those hormones raise a person’s blood pressure, quicken his pulse, constrict blood vessels and make blood platelets stickier, which increases the risk of blood clots.
“Contrary to the urban myth that it’s best to express anger and get it out there, expressing anger takes a toll on your system, and there’s nothing really cathartic about it,” O’Keefe said.
“[Anger] serves no purpose other than to corrode the short- and long-term health of your heart and blood vessels,” he said.
In the study, patients on blood pressure medications known as beta blockers had a lower chance of having a heart attack following an angry outburst, Mostofsky’s team notes in its report.
That finding suggests that doctors might consider using those drugs preventively in people at risk of heart attack and prone to anger, the authors said.