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Some people have heart attacks during moments of anger

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Getting angry – even for just a few minutes – can change the functioning of your blood vessels, which may make heart attacks and strokes more likely. The finding could explain why some people experience these events during emotional outbursts.

This result comes from a study in young adults who seemed to be in good health. The participants were asked to think about past experiences that made them angry while various aspects of their circulatory health were measured. Perhaps unsurprisingly, none of them had a heart attack or stroke during this process, but they did experience impaired blood vessel functioning that has been linked to such outcomes.

This suggests that intense emotions could contribute to cardiac events in people who already have poor health, says Daichi Shimbo at Columbia University in New York.

Other kinds of research have suggested that heart attacks can be triggered by intense emotional experiences. For instance, one study found that in the hour before a heart attack, people were more than twice as likely to have experienced anger or emotional upset as during the same hour-long period the previous day. But the mechanism behind this remained unclear.

To investigate, Shimbo and his colleagues took 280 volunteers and randomly assigned them to undergo one of three different experiences that induce either anger, anxiety or sadness for 8 minutes, or just to count upwards until the time had elapsed as a comparison, while various measurements were taken.

These included taking blood samples, looking at their blood pressure and measuring the capacity of their blood vessels to dilate in response to a standard procedure where blood flow to the arm is restricted and then allowed to return.

Such dilation capacity is thought to be a measure of blood vessel health, with lower dilation capacity having been linked to a higher chance of heart attacks.

In the study, people who were asked to think and speak about a recent experience that made them angry had a fall in their blood vessel dilation capacity that lasted for about 40 minutes.

“It is possible that [these effects] occur routinely throughout the day or week with potentially long-term consequences,” the researchers wrote in their paper. “Repeated episodes of a negative emotion may affect cardiovascular physiology over time, causing… irreversible damage.”

The blood vessel response didn’t happen for people assigned to the anxiety or sadness experiences, or for those in the control group. And there was no difference for any of the groups in the other measurements.

The effects of anger on blood vessel functioning fit with observations that heart attacks occasionally seem to be triggered by intense emotions, says Andrew Steptoe at University College London. However, it isn’t necessarily easy for people to stop getting angry, he says. “If people have serious problems, there are anger management interventions, but it’s quite difficult, for some of these emotions, to modify them very well.”

Glenn Levine at Baylor College of Medicine in Houston, Texas, says: “While not all the mechanisms on how psychological states impact cardiovascular health have been elucidated, this study clearly takes us one step closer to defining such mechanisms.”

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