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Anger has been linked to heart disease. A new study suggests why.

New research suggests a possible reason frequent anger has been linked to an increased risk of cardiovascular disease.

FILE - This May 26, 2009 file photo shows a printout from an electrocardiogram machine in Missouri. Doctors are reporting that novel drugs may offer fresh ways to reduce heart risks beyond the usual medicines to lower cholesterol and blood pressure. One new study found that heart attack survivors benefited from a medicine long used to treat gout. Gene-targeting medicines also showed promise in studies discussed Monday, Nov. 18, 2019,  at an American Heart Association conference in Philadelphia. (AP Photo/Jeff Roberson)
FILE - This May 26, 2009 file photo shows a printout from an electrocardiogram machine in Missouri. Doctors are reporting that novel drugs may offer fresh ways to reduce heart risks beyond the usual medicines to lower cholesterol and blood pressure. One new study found that heart attack survivors benefited from a medicine long used to treat gout. Gene-targeting medicines also showed promise in studies discussed Monday, Nov. 18, 2019, at an American Heart Association conference in Philadelphia. (AP Photo/Jeff Roberson)Read moreJeff Roberson / AP

The phrase “anger kills” might have a more literal meaning: New research suggests a possible reason frequent anger has been linked to an increased risk of cardiovascular disease. The study, published Wednesday in the Journal of the American Heart Association, emphasizes the potential health risks associated with intense anger and illuminates the influence of negative emotions on our overall well-being.

Funded by the National Institutes of Health, the study involved 280 healthy adults who were randomly assigned to a different eight-minute task, each designed to elicit feelings of anger, anxiety, sadness, or neutrality. Before and after these emotional tasks, researchers assessed the participants’ endothelial health. Endothelial cells, which line the insides of blood vessels, are essential for maintaining vessel integrity and are vital for proper circulation and cardiovascular health.

The findings revealed that anger had a significant negative impact on endothelial function, limiting the blood vessels’ ability to dilate. The response was not as pronounced with anxiety or sadness.

According to Daichi Shimbo, a cardiologist and professor of medicine at Columbia University Irving Medical Center and the lead study author, this research marks a step toward understanding how different negative emotions particularly affect physical health.

“It's fascinating that anxiety and sadness did not have the same effect as anger, suggesting that the ways in which negative emotions contribute to heart disease differ,” Shimbo said.

The research team chose to study healthy individuals to avoid the confounding effects of chronic illnesses, such as diabetes, which can compromise vascular function. Shimbo noted that if participants had such conditions, they already could have affected blood vessels and it would be difficult to determine the effect of emotions alone on vascular health.

Brian Choi, a cardiologist and professor of medicine and radiology at George Washington University, said findings like these could prompt health-care providers to investigate therapies such as anger management to see if they could reduce the risk of cardiovascular disease.

“We often hear of someone suffering a heart attack during a highly distressing event. We’ve known that stress from anger can trigger a heart attack, but we didn’t understand why until this study, which elucidates the underlying mechanism,” Choi said.

Shimbo says he wants to delve further into the reasons anger detrimentally affects the heart, considering whether the cause is related to the sympathetic nervous response (the body’s alert system) or inflammation.

David Spiegel, an associate chair of psychiatry and behavioral sciences at Stanford University School of Medicine, said cases of mental illness, including depression and anxiety, have shot up in the past few years, with an estimated 31% of Americans reporting some sort of anxiety at some point in their lives. Anxiety and depression can often be expressed as anger.

He adds that while anger is a normal emotion, constant feelings of anger not only have long-term impacts on an individual — they can also impact others around them.

“The concern is that when people are angry all the time, they kind of have their foot on the accelerator and the brake. … So anger has its body costs,” Spiegel said. “It’s not only the person you’re angry at who pays the price when you’re angry, your body pays the price for it.”

Common treatments for anger management typically include cognitive-behavioral therapy, relaxation techniques, stress management strategies, and communication skills training.