Brief anger can affect the functioning of blood vessels, says new research

A brief episode of anger triggered by remembering past experiences can negatively impact the ability of blood vessels to relax, which is essential for good blood flow, according to new research published in the Journal of the American Heart Association.

Previous research has found that a decline in the ability of blood vessels to relax can increase the risk of developing atherosclerosis, which in turn can increase the risk of heart disease and stroke.

“Impaired vascular function is associated with an increased risk of heart attack and stroke,” says lead study author Daichi Shimbo, MD, professor of medicine at Columbia University Irving Medical Center in New York City. “Observational studies have linked feelings of negative emotions to having a heart attack or other cardiovascular disease. The most common negative emotion studied is anger, with fewer studies examining anxiety and sadness, which have also been linked to the risk of heart attack.”

In this study, the researchers investigated whether negative emotions – anger, sadness and fear – can have a negative effect on blood vessel function compared to a neutral emotion. The 280 adults in the study were randomly assigned to one of four emotional tasks for 8 minutes: recalling a personal memory that made them angry; evoking a personal memory of fear; reading a series of depressing sentences that evoked sadness; or counting to 100 repeatedly to induce an emotionally neutral state.

This protocol, “Putative mechanisms Underlying Myocardial infarction onset and emotions (PUME),” was described by the researchers in a previous paper.

Researchers assessed the cells lining each study participant’s blood vessels before the tasks and at various points afterward, looking for evidence of reduced blood vessel dilation, increased cell damage and/or reduced cell repair capacity. The measurements taken before the emotional tasks were repeated after the tasks were completed.

Measurements were taken for each participant at baseline (0 minutes) and at four different time points after experiencing the assigned emotional task: 3 minutes, 40 minutes, 70 minutes, and 100 minutes. The analysis showed:

• Tasks that evoked memories of past events that caused anger led to reduced blood vessel dilation, from zero to 40 minutes after the task. After 40 minutes the restriction was no longer present.
• There were no statistically significant changes in the participants’ blood vessels at any time after experiencing the emotional tasks of fear and sadness.

“We saw that invoking an angry state led to blood vessel dysfunction, although we don’t yet understand what could be causing these changes,” Shimbo said. “Research on the underlying links between anger and blood vessel dysfunction may help identify effective intervention targets for people at increased risk for cardiovascular events.”

According to a 2021 scientific statement from the American Heart Association, “Psychological Health, Well-Being, and the Mind-Heart-Body Connection,” mental well-being can positively or negatively impact a person’s health and risk factors for heart disease and stroke.

“This study adds nicely to the growing evidence base that mental well-being can influence cardiovascular health, and that intense acute emotional states, such as anger or stress, can lead to cardiovascular events,” said Glenn Levine, MD, FAHA, writing committee chairman of the scientific statement, and physician-in-chief and professor of medicine at Baylor College of Medicine, and chief of cardiology at the Michael E. DeBakey VA Medical Center, both in Houston.

‘For example, we know that intense sadness or similar emotions are a common trigger Takatsubo cardiomyopathyand events such as earthquakes or even a fan watching a world football match, which cause stress, can lead to a myocardial infarction and/or cardiac arrhythmia.

“This current study eloquently demonstrates how anger can negatively impact vascular endothelial health and function, and we know that the vascular endothelium, the lining of blood vessels, plays a key role in myocardial ischemia and atherosclerotic heart disease. Although not all mechanisms of how psychological states and health effects on cardiovascular health have been elucidated, this study clearly brings us one step closer to defining such mechanisms.”

Study background and details:

• The Putative mechanisms Underlying Myocardial infarction onset and Emotions (PUME) study is a randomized controlled experimental study conducted from August 2013 to May 2017.
• Participants were recruited from the community surrounding Columbia University Irving Medical Center in New York City.
• The participants were 18 years or older and healthy. In this study, “healthy” was defined as no history of heart disease, stroke, bypass surgery or stents, transient ischemic attack, peripheral arterial disease, heart failure, high blood pressure, high cholesterol, type 2 diabetes, or self-reported diagnosis of a mental illness. health disorder; not taking prescription medications or nutritional supplements; and currently does not smoke.
• The average age of the study participants was 26 years. About 50% of participants identified themselves as female. Approximately 40% of participants self-identified as white adults; 29% as Hispanic/Latino adults; 19% as Asian adults; and 14% as black adults.
• The health of the participants’ blood vessels was assessed before and after completing the emotional tasks with finger probes that detect changes in blood flow in the arteries.
• Before completing the emotional tasks, participants sat in a comfortable chair in a temperature-controlled room and were instructed to relax for 30 minutes. During this time, they were not allowed to talk, use their phones, read documents or sleep.
• After the participants relaxed for 30 minutes, researchers measured the participants’ blood pressure with a cuff and the corresponding heart rate. Two blood pressure measurements were taken one minute apart, then the dilation of the participants’ blood vessels was measured and blood samples were collected for testing. Repeated measurements of blood pressure and dilation were taken, and blood samples were collected again after completion of the assigned emotional task.
• Researchers determined the extent to which the participants’ blood vessels could not dilate by measuring blood flow in the participants’ non-dominant forearm. They assessed the damage to the participants’ blood vessels by counting the number of circulating biomarkers in the blood vessel lining in the blood and assessed the regenerative capacity of the participants’ vascular cells by measuring their circulating levels of bone marrow-derived cells, which are essential for recovery. .

The study’s limitations included that the participants were young and apparently healthy, “making it unclear whether the results would apply to older adults with other health problems, who would most likely be taking medications,” Shimbo noted. Furthermore, participants were observed in a healthcare setting, rather than real-world situations, and the study only assessed the short-term effects of evoked emotions.