From the Guidelines
Yes, anger is a risk factor for heart disease, as it can trigger physiological responses that increase the risk of developing cardiovascular problems, and managing anger is crucial to reduce this risk factor. Chronic anger and hostility can increase the risk of developing cardiovascular problems by triggering physiological responses that are harmful to heart health. When a person experiences anger, the body releases stress hormones like adrenaline and cortisol, which raise blood pressure, increase heart rate, and can damage blood vessel linings over time. These repeated stress responses can lead to inflammation, atherosclerosis (hardening of the arteries), and increased blood clotting potential.
Research has shown that individuals who frequently experience anger or have a hostile personality type may have a higher risk of developing coronary heart disease and are more likely to experience heart attacks, as documented in a study where those who experienced a higher level of anger were found to have a 3.2 times higher risk of having a fatal or nonfatal coronary event compared to those who reported the lowest level of anger 1. Additionally, anger episodes can serve as acute triggers for cardiac events in people who already have heart disease, with a relative risk of experiencing another MI of 2.3 within 2 hours of an anger episode in post-MI patients 1.
Some key points to consider include:
- Anger management may be an important component of a comprehensive cardiac rehabilitation program alongside traditional medical treatments
- Techniques such as cognitive behavioral therapy, mindfulness meditation, regular physical exercise, and stress management can help reduce this risk factor
- Psychosocial interventions with psychosocial risk factor education, coping skills training, and engagement in cardiac rehabilitation programs can improve treatment outcomes, quality of life, and adherence of patients with psychological disorders 1
- Assessment of psychological distress and other psychosocial concerns, including anger, warrant evaluation in cardiac rehabilitation 1
Overall, managing anger is crucial to reduce the risk of heart disease, and healthcare providers should be able to diagnose and treat psychological disorders, including anger, as part of a comprehensive approach to cardiovascular health 1.
From the Research
Anger as a Risk Factor for Heart Disease
- Anger has been linked to cardiovascular diseases (CVD) in the popular imagination, and empirical validation from case-control and prospective studies emerged in the 1970s 2.
- Chronic feelings of anger, cynical distrust, and antagonistic behavior are at least modestly associated with the risk of both initiation and progression of CVD 2.
- Anger/hostility is also linked to stress exposure and reactivity, exaggerated autonomic function, reduced heart rate variability, platelet aggregation, and inflammation 2.
Association Between Anger and Cardiovascular Events
- Anger and suppressed anger were associated with future major adverse cardiac events in patients with coronary artery disease (CAD) 3.
- Suppressed anger remained associated with the more rigorous endpoint of cardiac death or myocardial infarction after controlling for clinical characteristics 3.
- Anger expression is a dimension of anger that may be strongly related to coronary heart disease and stroke, with moderate levels of anger expression potentially reducing the risk of nonfatal myocardial infarction and stroke 4.
Types of Anger Expression and Cardiovascular Risk
- Distinct types of anger expression may differentially predict incident coronary heart disease (CHD), with constructive anger expression potentially lowering the risk of CHD in men, and destructive anger justification increasing the risk of CHD in both sexes 5.
- The association between anger expression type and CHD incidence may vary by gender, highlighting the importance of considering individual differences in anger expression and its relationship to cardiovascular risk 5.
Overlapping Affective Dispositions and Cardiovascular Risk
- Anger, anxiety, and depression are putative risk factors for coronary heart disease, but the overlap among these negative affects necessitates the development of more complex affect-disease models 6.
- Recognition of the overlap among negative affects has implications for the interpretation of prior studies, statistical analyses, prevention, and intervention in health psychology and behavioral medicine 6.