Show 1405: Why Does Anger Harm Your Heart?

This week, we’ll dive into the research on how emotions affect your heart health. Specifically, we talk with two scientists who have studied the impact of anger on blood vessels. How might that shape your risk of a heart attack? Can you change your impulse to react with anger when somebody else is thoughtless or rude?

Does Anger Harm Your Heart?

Decades ago, a pair of cardiologists noticed that many of their heart-attack patients had a similar emotional profile: impatient, hard-charging, competitive and irritable (International Journal of Psychiatry, May 1968). They inspired many investigators to look at the personality characteristics of people in research studies. The idea was to tease out whether time urgency, competitiveness or irritability and hostility were more important in determining the increased risk.

By the 1980s, some scientists had begun to determine that hostility, anger and cynical mistrust of others were more important than other aspects of the type A behavior pattern in driving cardiovascular risk (American Journal of Cardiology, Dec. 28, 1987). Dr. Redford Williams was one of the pre-eminent researchers in this field, confirming that anger can harm the heart.

Why Does Anger Harm Your Heart?

More recently, investigators have been striving to determine the mechanisms. What is it about anger and hostility that is so bad for the body? Scientists have learned that people have differing reactions to recalling a situation that made them angry. Some people can tell the anecdote like a story, without attaching much emotion to it in the retelling. For others, remembering the situation upsets them greatly and they become angry once again. They may even hang on to their anger for hours.

A study published earlier this year demonstrated that for these individuals, recalling something that made them angry affects the lining of their blood vessels. This surprisingly long-lasting reaction of the endothelium reduces the flexibility of their blood vessels, including their coronary arteries (Journal of the American Heart Association, May 1, 2024). Dr. Matthew Burg, one of the investigators, describes the study and its implications.

What Can You Do About Anger?

If your cholesterol is high, your doctor will probably prescribe a statin to lower it. When blood pressure is an apparent risk factor, you’ll be encouraged to control it with a medication. We know that loneliness, depression and hostility are bad for physical as well as emotional health. Surprisingly, though, few physicians appear to think they can or should intervene to change hostile reactions. Perhaps they don’t think that is possible, or maybe they just don’t know how. No doubt they might benefit from training in medical school to help them (Academic Psychiatry, May-June 2008).

You Can Change Your Reactions:

Dr. Williams and his wife Virginia have written about a number of strategies to help people moderate their tendency to react with hostility to any challenge. The first step could be to recognize when you are angry and what triggered that emotion. Keep in mind that sometimes anger may be useful. Dr. Williams suggests this shortcut: I AM worth it. I stands for is this matter Important? A: is my anger Appropriate? M reminds us to assess if the situation can be Modified. Then we need to evaluate if the action we would take would be WORTH IT. If so, then the next step is to take the most effective action possible.

Cognitive Behavior Therapy can be a great help. The Life Skills that Redford and Virginia Williams recommend are also impactful. Learning to listen carefully and respectfully and reflect back what you have heard can make a huge difference in relationships.

Ideally, this type of training would be part of every middle school curriculum. Helping people change before their cardiovascular systems have been exposed to years of damage could contribute to life-long health. The most important message, in conclusion, is that even if you discover you are a hostile individual in too many situations, you CAN change. And changing could save your life.

This Week's Guests:

Matthew M. Burg, PhD, is Professor of Medicine in the section of Cardiology at Yale School of Medicine. His website is: https://medicine.yale.edu/profile/matthew-burg/  Dr. Burg is author of Psychological Treatment of Cardiac Patients

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Redford Williams Jr, MD, is Professor Emeritus of Psychiatry and Behavioral Sciences at Duke University School of Medicine. His website is https://medicine.duke.edu/profile/redford-b-williams
His books, co-authored with Virginia Williams, PhD, include Anger Kills: 17 Strategies for Controlling the Hostility that Can Harm Your Health; Lifeskills: 8 Simple Ways to build Stronger Relationships, Communicate More Clearly, and Improve Your Health; and In Control: No More Snapping at Your Family, Sulking at Work, Steaming in the Grocery Line, Seething in Meetings, Stuffing Your Frustration.

[caption id="attachment_132652" align="alignnone" width="260"] Redford Williams, Jr, MD, Professor Emeritus Duke University[/caption]