Anger management: The key to staying heart healthy?

February 23, 2009

New research published in the March 3, 2009, issue of the Journal of the American College of Cardiology finds that anger-induced electrical changes in the heart can predict future arrhythmias in patients with implantable cardioverter-defibrillators (ICDs).

While previous studies have demonstrated an increased incidence of sudden cardiac death during times of population stress such as earthquake and war, this study provides the first evidence that changes brought on by anger and other strong emotions can predict arrhythmias and may link mental stress to sudden cardiac arrest--which accounts for over 400,000 deaths each year.

"It's an important study because we are beginning to understand how anger and other types of mental stress can trigger potentially lethal ventricular arrhythmias, especially among patients with structural heart abnormalities," says Rachel Lampert, M.D., F.A.C.C., associate professor, Yale University School of Medicine.

Researchers studied 62 patients with ICDs who underwent monitoring during a mental stress test. Patients who had coronary artery disease or dilated cardiomyopathy (a condition in which the heart muscle are enlarged) and a standard indication for ICD were recruited from the Yale Electrophysiology practice. The mental stress test, conducted in a laboratory setting shortly after ICD implantation (about 3 months), asked patients to recall a recent situation in which they were angry or aggravated. T-wave alternans (TWA), a measure of the heart's electrical stability, was analyzed during this test. Researchers then followed patients for a mean of 37 months to determine which had arrhythmias requiring termination by the ICD.

"We know strong emotion increases sympathetic arousal," says Dr. Lampert. "In this study, we found patients with higher levels of anger-induced TWA were more likely to experience arrhythmias requiring ICD termination."

Patients with ICD-terminated arrhythmias during follow up (16%) had higher TWA induced by anger compared with those patients who did not have future arrhythmias. Even when other clinical factors that predispose patients to higher TWA levels and/or higher risk of ventricular tachycardia/ventricular fibrillation were controlled for (e.g., heart failure or history of arrhythmia), anger-induced TWA remained a significant predictor of arrhythmias, which led to a heightened risk of up to ten times that of other patients.

The development of accurate, non-invasive risk stratification tests to identify those individuals at greatest risk for life-threatening arrhythmia is critical. The present study suggests that mental stress, namely anger, may be yet another pathway provoking arrhythmias.

"What remains unclear is how this new T-wave alternans test relates to traditional exercise TWA testing," according to Eric J. Rashba, M.D., professor of Medicine, Stony Brook University Medical Center. "It may be that combining exercise TWA tests with newer mental stress TWA tests may help clinicians better select patients likely to have arrhythmia and, in turn, benefit from a defibrillator; however, more study is needed."

In contrast to exercise, mental stress doesn't elevate one's heart rate much, suggesting that changes seen with mental stress may be due to a direct effect of adrenaline on the heart cells. Therefore, mental stress testing could provide an alternative to atrial pacing for patients unable to exercise, according to Dr. Lampert.

"More research is needed, but these data suggest that therapies focused on helping patients deal with anger and other negative emotions may help reduce arrhythmias and, therefore, sudden cardiac death in certain patients."

Source: American College of Cardiology

Explore further: One day, many ideas: Future of Mind 2016 illuminates NYC (Part 1)

Related Stories

Enzyme research provides a new picture of depression

November 29, 2016

Depression is the predominant mental disease and constitutes the most common cause of morbidity in developed countries. Now researchers at Karolinska Institutet have managed to find a connection between development of depression ...

Reconditioning the brain to overcome fear

November 21, 2016

Researchers have discovered a way to remove specific fears from the brain, using a combination of artificial intelligence and brain scanning technology. Their technique, published in the inaugural edition of Nature Human ...

Recommended for you

Baby teethers soothe, but many contain low levels of BPA

December 7, 2016

Bisphenol-A (BPA), parabens and antimicrobials are widely used in personal care products and plastics. The U.S. and other governments have banned or restricted some of these compounds' use in certain products for babies and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.