Anger may raise heart attack risk, study finds

By Trevor Stokes
Reuters
Article from http://vitals.nbcnews.com/_news/

Bottling up emotions is thought to harm both mind and body, but a new study suggests that the opposite extreme may be no better.

In a study of thousands of 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, postdoctoral fellow with the Cardiovascular Epidemiology Research Unit at Harvard Medical School in Boston.

The greater the fury - including throwing objects and threatening others - the higher the risk, Mostofsky's team reports in The American Journal of Cardiology. The most intense outbursts were linked to a more than four-fold higher risk while milder bouts of anger were tied to less than twice the risk.

"The association is consistently stronger with increasing anger intensity; it's not just that any anger is going to increase your risk," Mostofsky told Reuters Health

The data came from a group of 3,886 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, as well as about their diets, lifestyles, exercise habits and medication use.

A total of 1,484 participants reported having outbursts of anger in the previous year, 110 of whom 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 people to lose control.

The researchers found that with each increment of anger intensity, the risk of heart attack in the next two hours rose. That risk was 1.7 times greater after feeling "moderately angry, so hassled it shows in your voice;" and 2.3 times greater after feeling "very tense, body tense, clenching fists or teeth" and 4.5 times greater after feeling "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 Dr. James O'Keefe Jr, a cardiologist at St. Luke's Hospital in Kansas City who wasn't involved in the research.

Anger is an emotion that releases the fight-or-flight-response chemicals epinephrine and norepinephrine, he said.

Those hormones raise our blood pressure, our pulse, constrict blood vessels, make blood platelets stickier (increasing the risk of blood clots), which O'Keefe says could be one way anger may be associated with increased heart risk.

"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 told Reuters Health.

"(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 reduced chance of having a heart attack following an angry outburst, Mostofsky's team notes in their report.

The authors say that finding suggests doctors might consider using those drugs preventively in people at risk of heart attack and prone to anger.

In discussing other possibilities for protecting people at risk, the researchers also write that during the 1990s when the data were collected, not enough study participants were on the newer statin drugs to determine their potential effects on heart attack risk.

Similarly, the number of participants who were on antidepressants was too low to tell whether they would have made a difference. would have made a difference.

Regular exercise, Mostofsky and her colleagues write, has been shown to lower overall heart attack risk. Though they found no differences in the link between angry outbursts and short-term heart attack risk among regular exercisers in the study, they conclude that maintaining an active lifestyle couldn't hurt.

The study is part of a broader field of research looking at managing the effects of emotional states on cardiovascular systems, said Donald Edmondson, assistant professor of behavioral medicine at Columbia University Medical Center in New York, who studies heart attack survivors but was not involved in the new work.

"People prone to angry outbursts or more broadly, who are prone to anxiety, depression or other intense emotions should be aware that this is something that impacts their cardiovascular system," Edmondson told Reuters Health.

Trevor Stokes
Reuters
Article from http://vitals.nbcnews.com/_news/

Turn the hopelessness within you into a fruitful opportunity. By RIDO

7 Mistaken Assumptions Angry People Make

By Marie Hartwell-Walker, Ed.D.
Article from http://psychcentral.com/

“I guess I have an anger problem. I lose my temper pretty quick. But it’s not like my wife doesn’t do things to make me mad.”

Richard has reluctantly come to treatment because his wife took out a restraining order after their last fight. He admits he lost control. He acknowledges that maybe he said things he shouldn’t have. But he also thinks she shouldn’t have done or said what she did. “I can’t help getting mad when she jerks my chain. I can’t let her get away with that!” he says.

What Richard doesn’t yet understand is this: Temper isn’t something you lose. It’s something you decide to throw away.

Raging, shouting, name-calling, throwing things and threatening harm is all a big bluff. It’s the human equivalent of animal behavior. From the puffer fish that puffs itself up to twice its size to look more intimidating to the lion on the veldt who shakes his mane and roars, creatures who feel threatened posture and threaten in order to protect themselves and their turf. The display often is enough to get the predator or interloper to back off. If not, the fight — or flight — is on.

People who rage are the same. Feeling a threat, they posture. They throw away all mature controls and rant and rage like an out-of-control 2-year-old. It’s impressive. It’s scary. It gets folks around them to walk around on eggshells. Others often let them “win” just to get away.

But are they happy? Usually not. When I talk to the Richards of the world, they usually just want things to go right. They want respect. They want their kids and their partners to give them the authority they think they deserve. Sadly, their tactics backfire. Not knowing what might set him off, kids, partners, coworkers and friends distance and leave him more and more alone.

Helping someone like Richard with “anger management” requires more than helping him learn how to express his angry feelings appropriately. Giving him practical skills alone assumes more control than he can probably hold on to. To be able to integrate those skills into his self-image, he needs to reconsider some of his basic assumptions about life and his place in it.

7 Mistaken Assumptions Angry People Often Make

1.     They can’t help it. Angry people have lots of excuses. Women will blame their PMS. Both sexes will blame their stress, their exhaustion, or their worries. Never mind that other people who have PMS or who are stressed, tired, or worried don’t pop off at the world. Angry people don’t yet understand that they are actually giving themselves permission to rant. In that sense, they are very much in control.
2.     The only way to express anger is to explode. People who rage believe that anger is like the buildup of steam in an overheated steam engine. They think they need to blow off the steam in order to be OK. In fact, raging tends only to produce more of the same.
3.     Frustration is intolerable. Angry people can’t sit with frustration, anxiety or fear. To them, such feelings are a signal that they are being challenged. When life doesn’t go their way, when someone doesn’t see things as they do, when their best-laid plans get interrupted or they make a mistake, they simply can’t tolerate it. To them, it’s better to blow than to be left with those feelings. They don’t get it that frustration is a normal part of everyone’s life and that it is often the source of creativity and inspiration.
4.     It’s more important to win than to be right. Chronically angry people often have the idea that their status is at stake when there is conflict. When questioned, they take it overly personally. If they are losing an argument, they experience a loss of self-esteem. At that moment, they need to assert their authority, even if they are wrong. When it is certain that they are wrong, they will find a way to prove that the other person is more wrong. For mature people, self-esteem is grounded in being able to put ego aside in order to find the best solution.
5.     “Respect” means that people do things their way. When another driver tailgates, when a partner refuses to go along with a plan, when a kid doesn’t jump when told to do something, they feel disrespected. To them, disrespect is intolerable. Making a lot of noise and threatening is their way of reasserting their right to “respect” by others. Sadly, when the basis of “respect” is fear, it takes a toll on love and caring.
6.     The way to make things right is to fight. Some angry people have learned at the feet of a master. Having grown up with parents who fight, it is their “normal.” They haven’t a clue how to negotiate differences or manage conflict except by escalating. Then they become very much like the parent they loathed and feared when they were kids.
7.     Other people should understand that they didn’t mean what they did or said when they were angry. Angry people feel that anger entitles them to let loose. It’s up to other people not to take seriously hurtful things they say or do. After all, they say, they were just angry. They don’t get it that other people are legitimately hurt, embarrassed, humiliated, or afraid.

Helping my patient Richard means helping him identify which of these assumptions are driving his temper tantrums. Some or all may apply. He may even have a few that are more uniquely his own. Teaching him rules for anger management, although important, isn’t enough to have long-term impact. Changing his assumptions will enable him to use such skills with conviction and confidence.

Marie Hartwell-Walker, Ed.D.
Article from http://psychcentral.com/

Turn the hopelessness within you into a fruitful opportunity. By RIDO