Daichi Shimbo. Photo: Jorg Meyer.

Anger is known to increase the risk of having a heart attack and stroke, but how anger raises the risk is not well understood. 

A new study led by a Columbia investigator suggests the connection may lie in the body’s blood vessels and arteries. The study found that a brief eight-minute bout of anger impairs the ability of blood vessels to dilate, raising the possibility that over time anger causes long-term vascular damage that has been linked to atherosclerosis, or hardening of the arteries, a precursor to heart attacks and strokes. 

“The research provides a better understanding of the connection between mental health and physical health and how even brief mild to moderate anger can increase a person’s risk of heart disease and stroke,” says the study’s leader Daichi Shimbo, professor of medicine at Columbia University Vagelos College of Physicians and Surgeons. 

“Identifying the link between anger and heart disease could also lead to effective interventions for those who are at risk for heart attack and improve overall well-being.”  

Negative emotions including acute anger, anxiety, and sadness have been linked in previous studies with an increased risk for heart attacks and strokes, but there has been insufficient data on how and why these emotions can affect cardiovascular health, Shimbo says. 

In the new Columbia study, the researchers recruited 280 healthy adults who had no history of heart disease, stroke, or serious mental health conditions. The research team wanted to conduct the study with individuals who had no chronic illnesses that could influence blood vessel function and make it more difficult to determine the effect of negative emotions on vascular health, Shimbo says.  

Each participant was brought into the lab and randomly assigned to spend eight minutes doing a validated task that induces anger, sadness, anxiety, or an emotionally neutral condition. Blood pressure and measures of vascular health were assessed before and after the tasks. 

The researchers found that the anger group’s blood vessels became impaired in dilating in response to ischemia for up to 40 minutes after the emotional experience.  

“The effects in this study were transient,” Shimbo says. “But I speculate that a person who gets angry over and over again is building up cumulative injury to their blood vessels.” 

No changes were seen among the participants in the sad or anxious groups. 

“What we learned is that not all negative emotions are the same,” Shimbo says. “The connection between sadness and anxiety to adverse heart conditions may come from another mechanism, but these types of negative emotions aren’t causing the blood vessel dysfunction we see when someone gets angry.” 

Because most people in the study were young, and all were healthy, Shimbo wants to repeat the study with older individuals with high blood pressure and diabetes who already have a high risk of heart attack and stroke. 

“In anger-prone individuals, we may be able to identify an unknown biological pathway among these people that causes anger to have such toxic effects,” he says.  

Keeping anger in check, remaining as calm as possible, and finding ways to manage emotions before they result in angry outbreaks may be critical in mitigating cardiovascular health risk, Shimbo says.  

“What this study shows us is that anger is not benign,” he says. “We all understand that something needs to be done to help people with anger, whether it is cognitive behavioral therapy or some other method because, plain and simple, anger is bad for your health.”