Studies show that feelings of anger and hostility are associated with an increased risk of heart disease. But researchers from Johns Hopkins University wondered whether high levels of anger in young adulthood increase a man’s risk of developing heart disease prematurely—before age 55. Their research, published in a recent issue of
Archives of Internal Medicine
, suggests that high levels of anger do increase a man’s risk of premature heart disease, and heart attack in particular.
About the study
The Johns Hopkins researchers studied 1055 men in the Johns Hopkins Precursors Study—a study of male physicians that began in 1948. Men were enrolled in the Precursors Study while they were in medical school between 1948 and 1964. Upon entering the study, each man underwent a complete medical exam and completed questionnaires about personal and family health history, health status, lifestyle behaviors, and reactions to stress. They also completed follow-up questionnaires annually until 1995. Medical conditions that were reported on these questionnaires—such as heart disease and heart attack—were verified with medical records and the National Death Index. Average follow-up in this study was 36 years.
Anger was measured with the Habits of Nervous Tension questionnaire, which contained a question about reactions to situations of undue pressure or stress. Three reactions to pressure and stress were defined as indicating anger:
Expressed or concealed anger
Men who had all three anger reactions were considered to have a high level of anger; less than three was considered a lower level of anger.
For this recent analysis, the researchers compared the anger reactions among those who developed heart disease or heart attack with those who did not.
Men with the highest levels of anger (all three reactions) were 3 times more likely to develop heart disease before age 55 than their calmer counterparts.
, these same men were 5 times more likely to have a heart attack before age 55 than their calmer counterparts. However, the risk of developing heart disease after age 55 was not significantly different between the two groups.
Although these results are interesting, there are limitations to this study. The participants were white men of high socioeconomic status in relatively stressful work environments, so it is unclear how these findings apply to women and people of other socioeconomic, ethnic, and racial groups. In addition, measures of anger were based on self-assessments by the participants rather than on the observations of a mental health professional during an interview. Finally, because there were relatively few men in the highest anger category, a single misclassification could significantly affect the results.
How does this affect you?
Will getting a handle on your anger protect you from heart disease and a heart attack? Possibly. This study confirms the findings of similar studies that consistent anger and stress can increase your risk of heart disease and stroke. Minimizing angry reactions to stress in your life can also reduce anxiety, improve your mental health, and reduce tensions in work, family, and social relationships.
To help reduce mental and emotional stress in your life, consider talking to a counselor about problems or stressful relationships in your life or learn relaxation exercises, yoga, or Tai chi. A regular routine of physical activity can also help reduce stress. Talk to your health care provider about which stress management options may be best for you, and request a referral to a program that seems to best suit your needs.
Chang PP, et al. Anger in young men and subsequent premature cardiovascular disease. The Precursors Study.
Archives of Internal Medicine
. April 22, 2002;162:901-906.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a