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Anger, chronic stress tied to heart disease

Heart • • StressSep 25, 07

For men with borderline-high blood pressure, an angry disposition may worsen the problem and raise the risk of eventual heart disease, a study published Monday suggests.

What’s more, researchers found, long-term stress may do the same in both men and women.

Both chronic stress and anger-prone personalities have been linked to heart disease risk before. The new findings point to the particular effects these factors may have on people with “prehypertension,” lead study author Dr. Marty S. Player told Reuters Health.

“This gives us a better understanding of risks related to this relatively new blood pressure category,” explained Player, of the Medical University of South Carolina in Charleston.

Prehypertension is a risk factor for full-blown high blood pressure. Normal blood pressure is anything under 120/80—the upper (systolic) and lower (diastolic) blood pressure readings; prehypertension is defined as a systolic blood pressure of 120 to 139, or a diastolic pressure of 80 to 89, Player and his colleagues explain in their report in the Annals of Family Medicine.

To investigate the effects of psychological factors on the progression of prehypertension, the team used data from a long-term study of heart disease risk factors among Americans ages 45 to 64.

Early in that study, participants completed standard questionnaires about chronic psychological stress and “trait anger”—the tendency to have a generally negative, hostile outlook and angry reactions to perceived slights.

Player’s team focused on 2,334 study participants who were initially free of heart problems but had prehypertension. They found that among men, those who scored high on the anger measure were 71 percent more likely than their more mellow peers to develop high blood pressure—i.e., 140/90 or more—over the next four to eight years.

Similarly, their risk of heart disease was nearly two-fold higher.

For both men and women, chronic stress seemed to drive up the risk of progressing to heart disease. They were 68 percent more likely to develop coronary heart disease than men and women who reported low or moderate stress levels.

Experts have speculated that chronic anger and stress contribute to heart disease by causing sustained nervous-system activation. People with hostile temperaments may also be resistant to changing their lifestyle habits or following medical advice.

It’s not clear whether learning stress management or anger control can ward off heart disease. Player noted that one study has found that exercise may improve both heart risk factors and aspects of the “type A” personality in middle-aged adults.

“I think overall, however, research needs to turn in the direction of looking closer at treatment of various psychological factors to see if there is an impact on (heart disease),” Player said.

Without well-designed clinical trials, he added, “we just cannot say” whether counseling, exercise or other therapies for anger and stress ultimately aid the heart.

SOURCE: Annals of Family Medicine, September/October 2007.

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