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Intense anger, anxiety increase short-term MI risk
Patients who experienced intense episodes of anger or anxiety had a significantly increased risk for acute coronary occlusion within the subsequent 2 hours, according to results published in European Heart Journal: Acute Cardiovascular Care.
Researchers evaluated self-reported anger episodes among 313 patients with acute coronary occlusion. All patients were treated from 2006 to 2012 at a single primary angioplasty facility in Sydney.
Patients responded to a questionnaire within 4 days of admission to assess activity within 48 hours of MI, including exposure to anger. Anger levels were rated on a seven-point scale, ranging from 1 (calm) to 7 (enraged and out of control), and episodes within the 48-hour period were compared with patients’ reported annual exposure to anger.
Seven patients reported anger at a level of 5 or higher on the scale, defined as “very angry,” within 2 hours of MI. The researchers observed an increased risk for MI symptoms among patients experiencing this level of anger compared with usual anger frequency (RR = 8.5; 95% CI, 4.1-17.6). MI symptom risk was not associated with anger at a level less than 5 on the scale during the evaluated time period.
Results from the State-Trait Personality Inventory indicated higher anger and anxiety scores within 2 hours of MI compared with 24 to 26 hours. Risk for MI symptoms was significantly associated with anger scores (RR = 2.6; 95% CI, 1.2-5.93) and anxiety scores (RR = 9.5; 95% CI, 2.2-40.8) greater than the 90th percentile.
The researchers concluded that these results “add to the small but growing body of evidence linking acute emotional triggers with onset of MI.” They added that there is a need for greater attention to the events preceding symptom onset among patients with MI, as emotionally triggered MI has been linked to poor long-term mental health.
“While the absolute risk of any one anger episode triggering a heart attack is low, our data demonstrate that the danger is real and still there,” Thomas Buckley, PhD, from the department of cardiology at Royal North Shore Hospital in Sydney, said in a press release. “Potential preventive approaches may be stress-reduction training to limit the responses of anger and anxiety, or avoiding activities that usually prompt such intense reactions. For those at very high risk, one could potentially consider protective medication therapy at the time of or just prior to an episode, a strategy we have shown to be feasible in other studies.” – by Adam Taliercio
Disclosure: The researchers report no relevant financial disclosures.