In the United States, about 750,000 people have a heart attack every year, and about 530,000 of these are the first heart attacks. Common risk factors for heart attack include hypertension, high cholesterol levels and smoking. But more and more researchers are studying how psychological factors can trigger the phenomenon. Conducted by researchers from the University of Sydney in Australia, the study also reveals that this increased risk of heart attack, or myocardial infarction (MI), lasts for 2 hours after an episode of intense rage. The link between anger and increased risk of heart attack is not new. In March 2014, a study by researchers at Harvard School of Public Health in Boston, Massachusetts suggested that explosions of rabies could increase the risk of heart attack, stroke and other cardiovascular events. “Our results confirm what has been suggested in previous studies and anecdotal evidence, including in films – that episodes of intense rage may act as triggers for a heart attack,” says study lead author Dr. Thomas Buckley.
To reach their findings published in the European Heart Journal: Acute Cardiovascular Care, Dr. Buckley and his team recruited 313 participants with acute coronary occlusion. All participants were admitted to a primary angioplasty center in Sydney between 2006 and 2012 with a suspected heart attack. Within 4 days of admission, participants were questioned about their activities within 48 hours prior to the onset of symptoms. He was asked to rate their rabies levels during these 48 hours on a scale of 1 to 7, with 1 indicating “calm” and 7 indicating “out of control”. The study reveals that patients who had periods of rabies on the 5 scale (indicating “very angry, body tensions, fists or clenched teeth, ready to burst”) or above in the 48 hours prior to the onset of symptoms, were 8, 5 times more likely to have a heart attack within 2 hours after a rash. In addition, the team found that people who experienced high levels of anxiety within 48 hours before the onset of symptoms were 9.5 times more likely to have a heart attack within the next 2 hours.
In a more recent study, the team was able to access other patient cohorts to confirm previous data. The researchers conducted a secondary analysis of the Determinants of Myocardial Infarction Onset Study (N = 2176, mean age = 60 years, 29.2% women). Immediately preceding (0-2 hours) anger and the day before (24 hours) were evaluated using a structured interview. The subsequent all-cause mortality at 10 years was determined using the US National Death Index. Anxiety during the pre-attack period (up to 2 hours before) was associated with younger age and female sex. Wrath in the pre-infarct period was also associated with the younger age, but not with sex. During follow-up, 580 (26.7%) patients died. The mortality rate was higher if the infarct occurred immediately after elevated anxiety, particularly in patients over 65 years of age. The data, on the whole, would indicate that those who have explosions of anger among the young are more at risk of having a stroke, but if the event happens in the over sixties this is associated with a higher mortality.
So calm and cold-blooded: before you explode, take a deep breath, sit down and talk to settle the situation. It will not be easy for those who have the “fiery” temperament, but could risk big otherwise.
- edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
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