People who experience an episode of intense anger are at an increased risk of suffering a heart attack within the next two hours, a new study has found.

The findings appear to confirm previous research which has suggested that anger can be a trigger for a heart attack.

Australian researchers assessed almost 700 people who attended a Sydney hospital with a suspected heart attack between 2006 and 2012. Of these, 313 were confirmed to have suffered an attack, also known as a myocardial infarction (MI), and were investigated further.

The researchers looked at levels of anger in the 48 hours preceding the MI. Participants were asked to give their anger a score between one and seven, with one being defined as ‘calm' and seven being defined as ‘enraged, out of control, throwing objects, hurting yourself or others'.

For the purpose of the study, the threshold of acute anger was considered to be level five - ‘very angry, body tense, maybe fists clenched, ready to burst'.

The study found that people who reached at least a level five in anger were 8.5 times more likely to suffer a heart attack in the two hours following that episode, when compared with people with lower levels of anger.

The types of events that triggered the anger included family arguments, work-related anger and driving-related anger.

The researchers said that the findings are ‘are consistent with previous reports in other populations' and suggest an ‘increased acceptance of the role of psychological factors in the onset of acute MI, sudden cardiac death and stroke'.

"While the absolute risk of any one anger episode triggering a heart attack is low, our data demonstrates that the danger is real and still there. This is most likely the result of increased heart rate and blood pressure, tightening of blood vessels and increased clotting, all associated with triggering of heart attacks," commented Dr Thomas Buckley of the University of Sydney.

He said that strategies need to be considered ‘to protect individuals most at risk during times of acute anger', and propensity to anger should be considered by doctors treating patients with heart disease.

"It should be part of helping individuals to take care of themselves. Potential preventive approaches may be stress-reduction training to limit the responses of anger and anxiety, or avoiding activities that usually prompt such intense reactions. Minimising other risk factors, such as hypertension or smoking, would also lower risk," Dr Buckley added.

Details of these findings are published in the European Heart Journal: Acute Cardiovascular Care.

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