How Getting Angry May Increase Your Risk of Heart Disease, Stroke

New research suggests that regularly getting angry may increase your risk of cardiovascular disease and stroke. Yana Iskayeva/Getty Images

• Anger appears to affect vascular health by diminishing blood vessels’ ability to dilate.
• Other negative emotions, such as sadness and anxiety, did not have this effect.
• The research highlights how your mental health can affect your body.

Anger is bad for your heart.

Researchers have discovered that anger is unique from other common negative emotions, such as sadness or anxiety, in its effects on vascular health. And while those effects may be reversible in the short term, repeated bouts of anger could have the potential to increase your risk of cardiovascular disease in the long run.

The findings were published this week in the Journal of the American Heart Association, and they shed more light on the complex relationship between mental health and physical health.

“We found that anger, but not the other emotions that we studied, had an adverse impact on vascular health. So there’s something about anger that’s what I call ‘cardiotoxic.’ So it’s a possible mechanism of why feelings of anger may be associated with increased heart disease risk,” Daichi Shimbo, MD, a Cardiologist and Professor of Medicine in the Division of Cardiology in the Department of Medicine at Columbia University Irving Medical Center, and first author of the study, told Healthline.

Abinash Achrekar, MD, MPH, Executive Vice Chair of Medicine in the division of cardiology at the University of New Mexico, who wasn’t affiliated with the research, called it “fantastic.”

“They have measured a way to look at our vascular biology, how healthy our cells are functioning, with something that’s so common to a human being: emotional state,” he said.

Anger may diminish vascular function

Shimbo and his team took a multidisciplinary or translational approach to their research. Translational research is often described as “bench to bedside,” or bridging the gap between laboratory science and real-world application.

Their goal was to investigate the relationship between emotional state and endothelial cell health, an overall indicator of vascular health. Endothelial cells line the interior of blood vessels and are an essential mechanism to maintain healthy blood flow throughout the body.

“Our blood vessels are not just tubes; they’re active organs that modulate themselves and function to either improve or sometimes worsen our cardiovascular overall health,” said Achrekar.

The study included 280 healthy adult participants randomized to one of four “emotional recall tasks.” During an emotional recall, the participants are asked to explore memories and experiences associated with a given emotion. In this case, participants were randomized to “anger,” “anxiety,” “sadness,” and an “emotionally neutral condition.” 

Following the session, researchers used a combination of serological markers to assess endothelial cell health. Additionally, they tested for reactive hyperemia, or how quickly blood vessels are able to expand and facilitate blood flow after an occlusion.

If you’ve ever fallen asleep on your arm and it has gone numb, you’ve experienced ischemia, lack of blood flow, in your limb. That “pins and needles” feeling you get when you move your arm is a result of blood flow returning. Reactive hyperemia indicates how quickly blood vessels can increase blood flow through the ischemic region.

Researchers found that anger negatively affected endothelial cell health by impairing the blood vessels’ ability to dilate, restricting blood flow. This impaired state persisted up to forty minutes after the recall exercise, before returning to baseline.

These findings were not identified for the other emotional states. 

“Our data suggest that maybe the mechanisms that explain anxiety and sadness in heart disease risk are different than those that explain anger. So it tells us: be careful about lumping different negative emotions in the same bucket,” said Shimbo.

The role anger can play in heart disease risk

Anger has profound effects on the body and mind, but it tends to fly under the radar in discussions about mental health. It is a strong emotion that taps deep into your “fight or flight” response. 

“It has a lot to do with threat. It’s both experiencing threat and expressing threat to others. It’s triggered in the base of the brain, the amygdala, and it stimulates sympathetic arousal that it is preparing the body to fight or flee,” said David Spiegel, MD, Associate Chair of Psychiatry & Behavioral Sciences, Director of the Center on Stress and Health and Director of the Center for Integrative Medicine at Stanford University School of Medicine. He wasn’t affiliated with the research.

When you get angry, your body is flooded with catecholamines, or stress hormones. Catacholamines include things like dopamine, epinephrine (adrenaline), and norepinephrine (noradrenaline). These hormones result in detectible physiological changes like a rapid heartbeat and increased blood pressure.

A famous study published by researchers at Harvard in 2014 found that following an angry outburst, an individual is at an increased risk of having a cardiovascular event like a heart attack or stroke, especially within the first two hours. They also found that the more frequently an individual had an episode of anger, the greater the risk of a cardiovascular event.

While the exact mechanism for how anger is associated with adverse cardiovascular outcomes may not be fully understood yet, it seems researchers are on the right path.

“It reminds us that the mind is indeed connected to the body. The paper shows that even transient, but intense experiences of anger seem to have an effect on the capacity for cardiovascular stimulation of blood flow,” said Spiegel.

The bottom line

Your emotional state can affect the health of your body. In a new study, researchers found that anger had deleterious effects on vascular health compared to other negative emotions like sadness and anxiety.

Anger appears to be uniquely harmful to the heart or “cardiotoxic.”

The research casts new light on the interconnectedness of the brain, mental health, and physical health.