Angry outburst could trigger heart attack within hours

Intense anger or anxiety greatly increases the risk of heart attack, a new study warns.

"While the absolute risk of any one anger episode triggering a heart attack is low, our data demonstrates that the danger is real and still there," said Dr. Thomas Buckley, a senior lecturer and researcher from the University of Sydney and Royal North Shore Hospital in Australia.

The increased risk of heart attack after intense anger or anxiety is "most likely the result of increased heart rate and blood pressure, tightening of blood vessels and increased clotting, all associated with triggering of heart attacks," Buckley said.

In the study, Buckley's team assessed more than 300 heart attack patients and asked them to use a 7-point scale to rate their levels of anger over the previous 48 hours. On the scale, 1 was calm, 5 was intense anger, and 7 was enraged/out of control.

Seven (2.2 percent) of the patients experienced at least level 5 within two hours before their heart attack and one patient reached that level within four hours before the heart attack. Level 4 (so hassled it shows in your voice) was reported by two patients within two hours before their heart attack, and by three patients within four hours before their heart attack.

The researchers concluded that the risk of heart attack in the two hours after a bout of intense anger or worse -- level 5 or more -- was 8.5 times higher than normal. They also found the risk of heart attack was 9.5 times higher than normal in the two hours after extreme anxiety.

The was published Feb. 23 in the European Heart Journal: Acute Cardiovascular Care.

The study couldn't prove cause-and-effect. However, Buckley's group believes the findings confirm those from prior studies, and highlight the need to find ways to protect people most at risk during bouts of extreme anger.

Events that triggered patients' anger-triggered heart attack included arguments with family members and other people, work conflicts, and road rage.

Doctors should check heart patients or people at risk of heart disease for anger and anxiety problems, Buckley suggested in a journal news release.

"Potential preventive approaches may be stress reduction training to limit the responses of anger and anxiety, or avoiding activities that usually prompt such intense reactions," he said.

"And for those at very high risk, one could potentially consider protective medication therapy at the time of or just prior to an episode, a strategy we have shown to be feasible in other studies," Buckley said.

Controlling high blood pressure and quitting smoking would also lower risk, he added.