Cardiac Heart Disease (CHD) And Anger

Dr. Peter Yellowlees MD, Cardiologist:

"Now two investigators from the University College, London, report in the Journal of the American College of Cardiology on the meta-analysis of 25 studies investigating CHD outcomes in initially healthy populations, and 19 studies of patients with existing CHD. The authors found that anger and hostility were associated with increased CHD events in the healthy population studies, and that this association was stronger for men than for women. In studies of subjects with CHD at baseline, the association with poor prognosis persisted. The authors concluded that anger and hostility are associated with worse CHD outcomes in both healthy and CHD populations."

I have deliberately posted this as a direct quote in order to drive home to everyone the seriousness of this issue. In discussing the problem of anger, rage and heart disease, it is important to clarify an important concept. It is normal to get angry and to express anger from time to time. It is unrealistic to think that anyone can live and function without ever getting angry. Rather, it is the way in which each person handles their anger that is the key to health or illness.

There are some people who are in a constant state of rage. My best example of this type of person was my late uncle, who was given to our bursts of anger. Ultimately, he suffered a coronary at age 75 and later died a painful death ten years later from a second and fatal heart attack.

I loved my uncle but there was no reasoning with him and that is something I keenly remember going back to my earliest childhood. He was an extremely intolerant man who valued only one opinion on any issue: his own. Yes, we all die in the end, but, it is a matter of how we die. Perhaps he could his death could have been less painful. In fact, during the ten years after his first attack, his temper did not improve.

My uncle was not a drinking man, however, there are a certain number of people whose anger issues are aggravated by drinking wine, beer and other such beverages. Under the influence, others find them to be quick to a type of anger that has not rationality behind it at all. While the medical establishment tells us that "moderate drinking," two glasses of wine for men and one for women two or three times per week, can be heart-healthy, it makes little difference if even that amoung makes someone more apt to explode angrily. Then, too, drinking above and beyond "moderation" carries with it all types of serious health problems.

This should be a warning to all of us to use our anger in ways that are healthy and adaptive. There are healthy means of expressing anger and coping with stress than exploding. For example:

Some suggestions for coping with anger:

1. When you feel anger beginning to erupt, take a time out, go to another room or walk around the corner and ask yourself if it is really worth it to your best interests to explode or yell?

2. The expression of anger is often more effective when the voice is lowered and the point is made without spewing out venom.

3. Keeping a journal and using it to express the frustrations with which you are dealing is often more adaptive than becoming openly angry because the process of writing can relieve a lot of that turmoil.

4. Returning to point number one, delaying the expression of anger often helps the person put things into perspective so that, thanks to the delay, they come to realize that the issue is really minor. Its a matter of selecting which problems are worth getting angry about and which are not.

5. If alcohol makes you angry, do not drink and get help with drinking if you cannot you drink too much.

These are just a few suggestions and I suggest that everyone read the very useful blogs about mindfullness, meditation and relaxation posted by our own Dr. Elisha Goldstein.

Remember, anger in and of itself is not the problem as much as the way we handle that anger. Road rage is an excellent example of the expression of anger that is potentially fatal because of how it affects the cardiovascular system. Even those who do not yell and scream in their cars while in a traffic jam, are harming their health by writhing with frustration and simmering rage due to traffic conditions.

No one is perfect and we all reach a point where we might get unnecessarily angry over taxes or something of that  nature. I believe we need to remember that there are those things we can help and those things we cannot. We have no control over traffic flow. Just sit and listen to music. You will be late for a meeting? So what!!!

Not only your thoughts and questions are welcome but your own coping ideas and suggestions. Let's hear from all of you.

Allan N. Schwartz, Ph.D.