Anger Management Training Institute

Youthful Anger Means Early Heart Disease

The young and the angry could wind up older and more prone to coronary heart disease (CHD). A Johns Hopkins Medical School study, 48 years in the making, confirms that young men who reacted to stress with anger were three times more likely to suffer from CHD before the age of 55 than their peers who said they let stressful situations roll off their backs.

Anger is no less deadly for women, according to the American Heart Association (AHA)A recent North Carolina study published in the journal Circulation looked at 256 men and women who have had heart attacks and showed that those prone to anger were also three times more likely to have a heart attack than those least prone to anger. The North Carolina researchers say the findings were true for individuals with normal blood pressure levels. Anger could lead to heart attacks, particularly among middle-aged men and women with normal blood pressure, the researchers said.Previous studies had suggested a correlation between anger and cardiovascular events, according to Patricia Chang, M.D., a cardiology fellow at Johns Hopkins University School of Medicine in Baltimore.

New studies focused on youth

"One study suggested that there was a higher incidence of anger remembered by heart attack victims a few hours prior to their heart attack. But studies that looked at anger in young people and the early onset of cardiovascular disease had not really been done.

"Chang used information developed during the Johns Hopkins Precursors study, first started in 1948, to see if there was a relationship between youthful anger and premature heart disease. "The study was started using questionnaires given out to each member of the graduating medical school classes [at Johns Hopkins Medical School] from 1948 to 1964," Chang notes. The study had a 90 percent average response rate. "The study continues in that we are following all these graduates with at least an annual health status questionnaire," Chang says.

One of the questions on the original questionnaire asked, "Whenever you find yourself in situations of undue pressure or stress, how do you react?" The young students then could check off any of 27 items. Those who checked "expressed or concealed anger, irritability and griping" in response to stressful simulations were deemed to have high levels of anger.

"What we found was that in our group of roughly 1,000 men, those who said when they were younger that they responded to stress with high levels of anger were five to six times more likely to develop heart attacks before the age of 55," Chang says. "And those who reported high levels of anger were up to three times more likely for other premature manifestations of coronary vascular disease, such as angina, hardening of the arteries, higher blood pressure, congestive heart failure and sudden death from heart disease.

"In another study, researchers found that people who scored high on a 10-item anger scale were more likely to be men and more likely to be smokers and drinkers. Those findings emerged from analyzing data from nearly 13,000 people who were followed for as long as six years as part of the Atherosclerosis Risk in Communities study.

What does anger do to your body?

Anger has serious physiological effects on the body, Chang says.

"Anger has been shown to narrow already diseased blood vessels," she says. "We know anger increases blood pressure as well as heart beat rates and adrenaline levels. In addition, anger may also cause platelets, which are the blood cells that form clots, to get sticky and clump, which of course can cause a blockage and a heart attack.

"Research results speak a lot to the fact that early behavioral effects, even if modified over time, can put you at risk for disease later in life, Chang says.

How to stay cool

So if you're an angry young man or woman, is there anything you can do?

"Well, you need to be aware of your response to stress, first," Chang advises. "And if you find your reaction to stress to include a high level of anger, coupled with complaining and irritability, then you need to learn how to calm down, how to get cool."

"(You) could look at behavioral modification for instance, such as anger management or stress reduction," she says. "What we do know is that studies show that if you learn to manage your anger after a heart attack, you are at lower risk for another one. What we don't know yet is if you manage your anger when you're young, whether it's clear whether that will prevent you from having coronary vascular disease.

"The American Heart Association suggests these tips to reduce stress:

• Talk with people you know, and love or trust about how you react to stressful situations.
• Take a break. Give yourself 15 to 20 minutes a day to sit quietly, breathe deeply, and think peaceful thoughts.
• You can't solve everything. First things first. Learn to accept that you can't control everything.
• Count to 10 before answering or responding when you feel angry.
• Don't use smoking, drinking, overeating, drugs or caffeine to cope with stress.
• Look for the good instead of the bad.
• Exercise regularly.
• Think ahead about what may upset you, and try to avoid it. Plan productive solutions to problems. For example, talk with your neighbor if the dog next door bothers you and set clear limits on how much you'll do for family members.
• Learn to say no. Don't promise too much. Give yourself enough time to get things done.
• Join a support group.
• Seek out a mental health professional or counselor if you can't cope on your own.

Neil Sherman