Study finds risk of heart attacks significantly increased if people are extremely angry or upset and exercising.
Getting very angry or upset more than doubles the risk of having a heart attack within an hour, scientists have found.
Doing intense exercise can also double the risk – while combining the two by exercising hard to burn off intense emotions can triple the risk.
An international study of more than 12,000 first-time heart attack patients from 52 countries found one in seven had either done heavy exercise or experienced intense emotions – or both – within the hour before the attack.
The risk was highest when heavy exercise was combined with anger or upset, such as in patients who had gone for a more extreme workout than usual because they felt furious about something which had happened to them.
The study, published in the American Heart Association’s journal Circulation, found said that these triggers appeared to increase the risk regardless of other factors which could cause a heart attack, including age, smoking, obesity, high blood pressure and other health problems.
There was no difference between feeling anger or upset – both types of intense emotion carried the same level of risk.
Scientists said the link could be explained because extreme emotions often have a similar physical effect on the body as heavy exercise.
Lead author Dr Andrew Smyth, of McMaster University in Canada, said: ‘Both (exercise and extreme emotions) can raise blood pressure and heart rate, changing the flow of blood through blood vessels and reducing blood supply to the heart.
‘This is particularly important in blood vessels already narrowed by plaque, which could block the flow of blood leading to a heart attack.’
Clinical psychologist, Barry J. Jacobs, of the Crozer-Keystone Family Medicine Residency Program in Springfield, Pennsylvania, said: ‘This large, nearly worldwide study provides more evidence of the crucial link between mind and body.
‘Excess anger, under the wrong conditions, can cause a life-threatening heart attack. All of us should practice mental wellness and avoid losing our temper to extremes.’
But researchers warned people not to stop regular exercise, which has been proven to reduce the risk of heart attacks.
Dr Smyth said: ‘Regular physical activity has many health benefits, including the prevention of heart disease, so we want that to continue.
‘However, we would recommend that a person who is angry or upset who wants to exercise to blow off steam not go beyond their normal routine to extremes of activity.’
Dr Jacobs added that people at risk of a heart attack should avoid ‘extreme emotional situations’ and may find talking therapies, such as support groups, a way to ‘cope with the emotional ups and downs of a health condition’.
For the study, researchers analysed data from 12,461 patients, with an average age of 58, who had had heart attacks for the first time.
The patients were asked whether they had experienced any of the triggers in the hour before their heart attack or on the day before.
In total, 13.6 per cent of patients reported doing heavy physical activity in the hour before their heart attack, while 14.4 per cent had experienced anger or emotional upset.
Previous studies have shown similar links, but this was the first to represent patients from so many different countries, cultures and ethnicities from around the world.
Limitations of the study included the fact participants had to recall the triggers and that there was no set definition of ‘angry’, ‘emotionally upset’ or ‘heavy physical exertion’.
The British Heart Foundation said that while the research suggested emotion or heavy physical exertion were triggers for heart attacks, they were not an underlying cause.
Maureen Talbot, senior cardiac nurse at the charity, said: ‘Heart attacks are mainly caused by atherosclerosis – the build-up of fatty plaque in the arteries. When plaque breaks off, a blood clot forms leading to a heart attack.
‘That’s why it’s important people know their heart attack risk and take steps to reduce their risk, by quitting smoking, keeping physically active and maintaining a healthy weight.’
Heart disease affects around 2.3million people in the UK and is the country’s biggest killer, claiming around 73,000 lives every year.