NIH-funded clinical trial links frequent anger to increased risk of heart disease

news release

Wednesday, May 1, 2024

Findings indicate impaired vascular function. It can cause heart attack and stroke.

A new study supported by the National Institutes of Health suggests that repeated angry emotions can limit the ability of blood vessels to open, increasing the risk of developing heart disease. This research American Heart Association Journal (JAHA) was the first to show that anger is associated with this vascular disorder, a precursor to long-term damage that can lead to heart attacks and strokes.

“Based on observational studies, we have long suspected that anger can have negative effects on the heart. This study in healthy adults helps fill a real knowledge gap. , shows how this happens,” said Dr. Laurie Friedman-Donze, a psychologist and program director in the Division of Clinical Applications and Prevention at the National Heart, Lung, and Blood Administration. Institute (NHLBI) that funded the research. “It also paves the way for promoting anger management interventions as a potential way to prevent heart disease, the leading cause of death in this country.”

Occasional sudden outbursts of anger are normal and generally have a benign effect on the heart, but recurrent or frequent bouts of anger are a cause for concern, researchers say. “People who are always angry have chronic damage to their blood vessels,” says study leader Dr. Daichi Shinbo, a cardiologist at Columbia University Irving Medical Center in New York City. “Over time, these chronic injuries can ultimately have an irreversible impact on vascular health and ultimately increase the risk of heart disease.”
For this randomized controlled study, researchers recruited 280 healthy adults between the ages of 18 and 73 in the New York City area. Based on self-reported survey data, participants had no cardiovascular disease or risk factors such as a history of hypertension, diabetes, or dyslipidemia. All participants were nonsmokers, took no medications, and had no history of diagnosed mood disorders.

The researchers measured changes in blood flow in blood vessels in each participant's dominant arm. They were then randomly assigned tasks that elicited either anger, anxiety, sadness, or a neutral emotional state.

Using standard methods for such laboratory experiments, the researchers asked participants in the anger and anxiety groups to talk for eight minutes about a personal experience that triggered those feelings. For eight minutes, he read a series of short sentences intended to evoke sadness for participants in the grief group. The control group counted numbers aloud for 8 minutes to induce an emotionally neutral state. After each group finished, the researchers measured blood vessel changes immediately after the task was finished and again at 3, 40, 70, and 100 minutes.
The researchers found that participants in the anger group had a significantly reduced ability to dilate blood vessels compared to participants in the control group. This vasculopathy persisted for up to 40 minutes after the initial anger-inducing recall event and then diminished. In contrast, blood vessels in the anxious and sad groups were unaffected.

Previous studies have shown that impaired vasodilation is a precursor to the development of impaired vasodilation. atherosclerosis – Accumulation of fatty deposits within the walls of blood vessels – this can lead to heart disease such as heart attack and stroke.

It is unclear why anger negatively affects vascular function, and this study was not designed to assess those mechanisms. However, Shinbo said several factors may be involved, including activation of the autonomic nervous system, changes caused by stress hormones, and increased arterial inflammation. Shinbo said the endothelium, the lining of blood vessels known to control the expansion of the blood vessels themselves, was also likely involved in some way. The researchers plan to investigate these possible mechanisms in future studies.
Because the participants were generally young and healthy, with an average age of 26, other studies will examine whether the results can be generalized to older people with health problems who are more likely to be taking medications. There is a need. Future research could also examine whether positive emotions, such as joy and laughter, can buffer the negative effects of anger on the heart.

NHLBI's Donze said controlling anger is important for people who get angry frequently. Helpful approaches include exercise, yoga, deep breathing, and cognitive behavioral therapy (CBT). His effective CBT strategies for anger management can also be learned from self-help books.

This research was primarily funded by NHLBI under grants R01 HL116470 and K24 HL125704. Clinicaltrials.gov registration number: NCT01909895.

About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is a world leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, please visit: www.nhlbi.nih.gov.

About the National Institutes of Health (NIH):The nation's medical research agency, NIH, has 27 institutes and centers and is part of the U.S. Department of Health and Human Services. NIH is the primary federal agency that conducts and supports basic, clinical, and translational medical research, investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, please visit: www.nih.gov.

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