Outbursts of Anger Increase Risk of Myocardial Infarction

The risk of experiencing acute myocardial infarction (AMI) is more than twofold greater after outbursts of anger compared with other times, according to a new study.

Researchers at Beth Israel Deaconess Medical Center (BIDMC; Boston, MA, USA) and Harvard School of Public Health (HSPH; Boston, MA, USA) conducted a case-crossover analysis of 3,886 participants from the multicenter Determinants of Myocardial Infarction Onset Study, who were interviewed during the index hospitalization for AMI from 1989 to 1996. The researchers compared the observed number and intensity of anger outbursts in the two hours preceding AMI symptom onset with its expected frequency according to each patient's control information, defined as the number of anger outbursts in the previous year.

The results showed that of the study participants, 1,484 (38%) reported outbursts of anger in the previous year, and the incidence rate of AMI onset was elevated 2.43-fold within two hours of an outburst of anger; the association was consistently stronger with increasing anger intensities. The researchers also found that compared with nonusers, regular β-blocker users had a lower susceptibility to heart attacks triggered by anger, suggesting that some drugs might lower the risk from each anger episode. The study was published in the July 22, 2013, issue of the American Journal of Cardiology.

“There is transiently higher risk of having a heart attack following an outburst of anger; the greater the fury—including throwing objects and threatening others—the higher the risk,” said lead author Elizabeth Mostofsky, MPH, of BIDMC. “The association is consistently stronger with increasing anger intensity; it's not just that any anger is going to increase your risk.”

Anger accompanies a rise in stress hormones such as cortisol and norepinephrine, released during the fight-or-flight response. These chemicals prepare our bodies for self-protective action, but the biochemical changes they trigger, including a spike in blood pressure and blood vessel constriction, also place immense strain on the heart.

Related Links:
Beth Israel Deaconess Medical Center
Harvard School of Public Health