By T. Jared Bunch, MD
Published Mar 13, 2014
Recently I visited one of my patients in the hospital who had experienced a heart attack. When I went into his room, his wife said, “I told him if he didn’t stop losing his temper this would happen.”
Fortunately, he recognized the heart attack symptoms quickly and went to the hospital for emergency treatment. A small stent was placed in an occluded coronary artery and he did well after.
But his case brings up an interesting question: Can losing your temper cause heart problems?
Anger and Heart Disease: The Evidence Is InJust like high blood pressure and cholesterol, exposure to emotional and psychological stress can cause heart problems.  For example, after the September 11 terrorist attacks on the World Trade Center in Manhattan, heart attacks and abnormal heart rhythms surged more than 35 percent in Brooklyn during the ensuing two months.  The events in Brooklyn are obviously an extreme example of exposure to stress, but they highlight the close relationship between the heart and mind. For most of us, stressful situations and anger are part of life. For many people these feelings can be controlled or suppressed, but others struggle to control them. Restraint of feelings of anger as opposed to outward outbursts of anger often become a daily drama for those people fortunate to have a commute to work during traffic congestion.
Is it better to restrain your anger and seek a calmer solution versus allowing the anger to bubble to the surface?   And if anger is allowed to go uncontrolled, does the accumulative effect hurt our physical bodies?
Heart Events in the Aftermath of AngerA recent study sought to answer these questions. The study was a meta-analysis of nine studies performed between 1995 and 2013. The authors looked at risk of myocardial infarction (heart attack), stroke, and abnormal heart rhythms during the two hours after an anger outburst.

  1. Myocardial infarction. There was a 4.74 times higher risk of experiencing a heart attack or severe chest pain from a nearly occluded coronary artery following an anger outburst.
  2. Stroke. There was a 3.63 times higher risk of having a stroke from a blood clot to the brain or bleeding within the brain during the 2 hours after an anger outburst. For people with an aneurysm of one of the arteries in the brain, there was a 6.3 times higher risk of rupturing this aneurysm following an outburst of anger.
  3. Abnormal heart rhythms from the lower heart chambers (ventricular arrhythmias).  Abnormal ventricular rhythms from the lower heart chambers can lead to cardiac arrest if they are fast and sustained. In regards to these abnormal heart rhythms, following an outburst of anger there was a 1.85 times higher rate of abnormal ventricular arrhythmias during the first 15 minutes. Although with time this risk lowered, during the next 2 hours there still was a noticeably higher risk of 1.35 times the normal rate.

What if you are a person who finds anger management a problem on a daily basis? Unfortunately this pattern is really a problem for your heart and body. For people who experience up to five episodes of anger outburst a day, the rate of experiencing a heart attack, stroke, or abnormal heart rhythm is dramatically increased. This increased risk is independent of all the other known causes of heart disease. For example, if you have no other risk factors for heart disease, such a high blood pressure, high cholesterol, etc., poor anger control increases your risk by 5 percent. If you have many traditional risk factors for heart disease, poor anger control increases your risk to 20 percent.
This study further expands our understanding of how emotions and mood can affect our entire body. Anger outbursts are common and can significantly impact your heart health. If you struggle with anger, seek help not only for those around you, but also for your own wellbeing.
There are many ways to help with anger control and our natural responses to stressful situations. Your heart is depending on your response.