Anger may harm heart and blood vessel health

Several studies have found links between negative emotions and cardiovascular problems. The underlying mechanisms have been unclear, but impaired blood vessel function may contribute. The inner lining of blood vessels, called the endothelium, is known to help control blood vessel dilation. Previous research suggests that faulty activity of endothelial cells may be an early step leading to atherosclerosis and other heart-related disorders.

A research team led by Dr. Daichi Shimbo of Columbia University set out to learn more about potential links between negative emotions and blood vessel function. They enrolled 280 adults, ages 18 and older, in the New York City area. The average age of participants was 26. About 40% were Caucasian, 29% Hispanic/Latino, 19% Asian, and 14% Black. All were considered healthy, with no reported history of heart disease, stroke, type 2 diabetes, high blood pressure, or other serious conditions. None reported taking medications or dietary supplements.

Participants were randomly assigned to one of four groups: anger, anxiety, sadness, or emotionally neutral. Those in the anger or anxiety groups were asked to recall and talk for eight minutes about a personal memory that evoked the assigned emotion. Those in the sadness group read aloud for eight minutes a series of sentences designed to elicit sadness. And those in the fourth group repeatedly counted to 100 for the same amount of time, which controlled for potential effects of speaking.

The researchers collected several measurements before and after the emotion-related task. These included blood pressure, heart rate, and blood tests. Specialized probes placed on participants’ index fingers were used to detect changes to blood vessel dilation. The team also tested for evidence of cell injury or reduced repair capacity in blood vessels. Measurements were taken at baseline and at 3, 40, 70, and 100 minutes after the task. Results were reported in the Journal of the American Heart Association on May 7, 2024.

Participants in the anger group had significant impairment to blood vessel dilation compared to the neutral group. This impairment continued for up to 40 minutes after the anger task had ended. Blood vessel function in the anxiety group may also have been impaired, but the effect wasn’t large enough to prove it wasn’t due to chance. Blood vessel function in the sadness group was not significantly affected. The team found no significant evidence of cell injury or repair problems in any group.

The researchers propose that repeated episodes of negative emotions like anger might have a cumulative effect on cardiovascular health. Over time, ongoing anger might lead to permanent damage and increased risk for cardiovascular disease.

“We’ve long suspected, based on observational studies, that anger can negatively affect the heart,” says Dr. Laurie Friedman Donze, an NIH psychologist and program officer. “This study in healthy adults helps fill a real knowledge gap and shows how this might occur.”

“We saw that evoking an angered state led to blood vessel dysfunction, though we don’t yet understand what may cause these changes,” Shimbo notes. “Investigation into the underlying links between anger and blood vessel dysfunction may help identify effective intervention targets for people at increased risk of cardiovascular events.”