Articles

Hostility, Anger May Be Bad For Male Heart

Virginia Anderson, AJC Staff
May 24, 2004

Picture this: A man is losing his temper. He's screaming and turning red-faced. His eyes bulge, his forehead drips sweat.

Or maybe he's in the corner brooding, feeling a little hostile. He thinks he's smarter than the people he works with. He never gets the recognition he thinks he deserves.

Both displays of emotions -- anger and hostility -- may put men at risk of a heart condition called atrial fibrillation, a recent study of about 1,800 men suggests.

Atrial fibrillation, in which the heart beats irregularly and too fast, plagues 2 million Americans. It can lead to stroke and heart failure; about 15 percent of people who suffer strokes have atrial fibrillation.

The study, published in March in Circulation, is significant not only because it shows a possible risk factor for stroke, but also because it adds to research that shows emotions and how people handle them can put them at risk for major illnesses. The findings suggest that losing your temper might hurt yourself more than others, the study's lead author said.

"Expressing anger in a highly dysfunctional way is detrimental to your health," said Elaine D. Eaker of Eaker Epidemiology Enterprises in Chili, Wis.

The primary danger of the irregular, fast heartbeat of atrial fibrillation is a pooling of blood in the atria, the two small upper chambers of the heart. That can lead to clotting and possibly stroke.

Yet atrial fibrillation is also a danger because it can stretch the fibers of the heart, explained Dr. John Beshai, a cardiologist and assistant professor of medicine at Emory University. Much as the extra movement of muscles in a gym causes targeted muscles to grow, the extra movement in the heart muscle caused by atrial fibrillation causes the heart to stretch.

"That stretch over time can create changes," said Beshai. "The [heart] muscle gets thicker because you're working it."

Big muscles might be coveted in some areas, but a large heart is not good. It can upset the heart's rhythm and raise blood pressure. The outcomes can vary from what Beshai calls "nuisance arrhythmia," or simply the uncomfortable feeling of one's heart pumping erratically, to, in rare cases, death.

"It can precipitate heart failure," Beshai said.

Treatment has typically included medication, such as beta blockers, or electrical shock to jolt the heart back into proper rhythm.

While atrial fibrillation typically has been a malady of old age, doctors have seen a disturbing increase in the condition in younger men and women. A study published last year in Circulation predicted that the condition will be a "staggering burden" on public health and patients' quality of life if doctors and patients do not act to curb the trend.

The number of hospitalizations in which the condition was listed as the first diagnosis among people 35 and older increased 144 percent from 154,086 in 1985 to 376,487 in 1999, according to the analysis of hospital discharge records. The number of hospitalizations in which atrial fibrillation was listed as a diagnosis jumped 190 percent from 787,750 to almost 2.3 million in the same 15-year period.

The recent study was an analysis of 1,769 men and 1,913 adult children and their spouses from the original participants in the Framingham Heart Study, begun in 1948. The participants completed psychological surveys when their average age was 48.5, and they had no sign of heart disease. They were then followed for 10 years.

Hostility, defined for the study as having a generally contemptuous attitude toward others, defensiveness and feelings that others take credit for things you have done, may affect atrial fibrillation more than anger, the study suggests. Men with higher feelings of hostility were 30 percent more likely to develop the condition, while men who scored high in anger had a 10 percent higher risk for developing atrial fibrillation than men without increased anger. Researchers aren't sure how the feelings cause the physiological changes.

The study showed no increased risk of atrial fibrillation for men who rated high on Type A behavior, typically actions that show time urgency and competitiveness rather than anger and hostility.

It also showed no increased risk of atrial fibrillation for women who feel angry or hostile. That could be because women and men do not express anger the same way, Eaker said.

Heredity, a history of scarlet fever and an alcohol overdose also can be contributing factors in atrial fibrillation.

Because the study did not address treatments, researchers need to follow up on Eaker's study to determine whether treatment for anger and hostility might lower the risk among men who have anger and hostility, she said.

"From a scientific standpoint, we cannot conclude that if you control your anger, you reduce your risk," Eaker said. "We can't go out on that limb."

Eaker did say, however, that counseling for anger and hostility is "certainly not going to be bad" if the displays of those emotions are detrimental to your health.

SYMPTOMS OF STROKE
• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

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