Anger and coronary artery disease

Townsend Letter for Doctors and Patients,  August-Sept, 2004  by Robert A. Anderson

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Among 12,986 black and white men and women enrolled in the Atherosclerosis Risk In Communities study, adjusted risks for combined CAD events (acute myocardial infarction/fatal coronary artery disease, silent MI, or cardiac revascularization procedures) and for "hard" events (AMI/fatal CAD) in those with high trait anger were 1.54 (95% CI 1.10-2.16) and 1.75 (95% CI 1.17-2.64), respectively, vs. their low anger counterparts. In normotensives, the RR for combined events with high vs. low anger was 2.20 (95% CI 1.36-3.55) and for "hard" events 2.69 (95% CI 1.48-4.90). No statistically significant association between trait anger and incident coronary artery disease risk was observed among hypertensives.

Williams JE et al. Anger proneness predicts coronary heart disease risk: prospective analysis from the atherosclerosis risk in communities (ARIC) study. Circulation 2000 May 2; 101(17):2034-9

COMMENT: Trait anger placed normotensive middle-aged men and women at significant risk for CAD morbidity and death independent of their established biological risk factors. In numerous studies, psychosocial risk factors for cardiac "events" and complications after heart attacks are significantly increased after controlling for all conventional risk factors (smoking, high cholesterol and blood pressure and diabetes). Indeed, several studies have shown that risks are greater for emotional distress (depression, grief, anger, hostility, anxiety) and for social isolation than for conventional biomedical risk factors.

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