Short-tempered young men triple their risk of having a heart attack

A recent study, conducted by scientists at Hopkins, asserts that young men who react violently to stress are three to five times more likely to suffer from a premature heart attack, regardless of a family history of heart disease.

Dr Patricia Chang, a researcher at Hopkins, who coordinated the U.S.-based research, said: "In this study, hot tempers predicted disease long before other traditional risk factors like diabetes and hypertension became apparent."

Chang and other scientists used data from the Johns Hopkins Precursors Study, a study of 1,337 medical students who were enrolled at Hopkins between 1948 and 1964.

In medical school and through the follow-up period, information on family history and health behaviors was collected. A total of 1,055 men were traced for an average of 36 years.

In the initial part of the study, conducted while the men were in medical school, they were given a "nervous tension" questionnaire designed to elucidate how they responded to stress.

Based on an article published in the Archives of Internal Medicine, men who had openly expressed or concealed anger, irritability or so-called "gripe session" were flagged for high anger levels.

There were 229 men who said that they expressed or concealed their anger, 169 said they engaged in gripe sessions and 99 said they were irritable. Of these men, 205 had developed cardiovascular disease by the age of 76, with an average onset age of 56. Seventy-seven men had premature cardiovascular disease, with an average onset age of 49.

Looking at these statistics, Chang comments, "Although the number of heart events was small, the incidence of cardiovascular disease was significantly higher for those with the highest level of anger, compared with those with lower levels of anger."

Chang did not know if these statistics were applicable to women as well as men because the study was only conducted among male participants.

Chang's research was supported by Alison Shaw from the British Heart Foundation who pointed out that similar studies suggest that people with hostile personalities are more likely to develop coronary heart disease (CHD).

"This new research is interesting, but it makes no mention of the other risk factors such as smoking or high blood pressure, which may have influenced the development of CHD in the participants," said Shaw.

Many other studies have found a correlation between risk factors such as smoking, a high cholesterol diet, seditary lifestyle and many others, with an increased chance of heart disease. However, it is often difficult to make a statistically significant correlation between a risk factor, such as stress or anger, and heart attacks because stress and anger are very difficult to measure quantitatively.

Everyone has a certain amount of stress and anger in their lives, but studies such as Chang's only count those people who have passes a so-called anger threshold, above which they are considered to be exhibiting extreme stress or anger.

Where this threshold line is drawn and how anger is measured in a quantitative form is very subjective. Often, with studies such as these, the research is more a measure of the threshold level chosen by the researcher than it is a measure of the actual correlation between anger and heart attack.

"In the long term, more large-scale research is needed that takes into account all the possible risk factors for CHD to give more insight into how psychosocial factors effect our hearts," Shaw continued.

While the direct connection between anger and heart-attack is unknown, Chang hypothesized that catecholamines, released in response to stress and which serve as natural neurotransmitters may be responsible.

Adrenaline, which is an example of a catecholamine, is responsible for initiating the "fight or flight" response when the body is placed in situations of extreme stress such as extreme cold, fright, fatigue and shock. Adrenaline ups blood pressure and breathing.

"The most important thing angry young men can do is get professional help to manage their tempers, especially since previous studies have shown that those who already have heart disease get better with anger management," warned Chang.