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Heart attack risk: the role anger plays and how to reduce it

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The American Heart Association suggests making lifestyle changes in order to avoid a second heart attack if you have been the victim of one in the past. But most people want to avoid one in the first place, and CBS News reported on March 4 that they can do that in part by controlling their anger.

Dr. Elizabeth Mostofsky, a Harvard School of Public Health epidemiology instructor in Boston, says that the risk is low of experiencing a heart attack with just one event of anger. However, "frequent episodes of anger" are another story, according to her.

After reviewing 4,500 studies dated from 1966 to 2013--which looked at anger's role in cardiovascular problems--her team learned that one lone anger event had the potential to result in one extra heart attack experience per every 10,000 people per year. And that's even if that person was at a low risk for heart problems and/or only had one anger issue per month.

But when people are at high risk for cardiovascular problems already, and they experience an anger issue, the potential for heart attack rises as much as four more attacks per 10,000 people per year.

More frequent anger outbursts, like getting angry five times a day, would result in an even greater number of heart attack incidents (regardless of whether the person was at low-risk or high-risk for cardiovascular problems). However, the high-risk individual would still be the most likely to have a heart attack due to their greater unresolved anger issues, experiencing almost as much as six times the number of extra heart attacks per 10,000 people versus the low-risk group.

So while the American Heart Association says that relieving stress and depression is one of the key lifestyle changes needed to help prevent heart attacks after you have had one, the Harvard School of Public Health is now showing that relieving stress from anger is just as important to do in advance of your first heart attack, as that anger can cause a heart attack as much as four hours after you have had the negative situation.

Therapy or medications could help with anger problems, according to HSPH, but they think more study is needed to know for sure. Researchers at two U.S. universities say they are not surprised to hear that physiologic effects of chronic anger could have such a detrimental impact on someone's heart, and they too want to know "how to prevent these dangerous anger episodes."

WebMD says that when it comes to stress and heart attack risk, "being able to identify the (anger) stressors in your life and releasing the tension they cause are the keys to managing stress." And they provide a list of common warning signs and symptoms of stress for their readers.

So how do you deal with anger issues and manage the stress they cause? These tips and techniques can help, which include not suppressing your anger, not directing it in hostile or inappropriate ways, but rather, finding out what is behind your anger (are you really angry, or is your anger masking other feelings, like embarrassment?). If you are angry, you have to come up with a way to deal with it successfully--or to prevent it from happening again. If you are embarrassed, you need to deal with that issue instead.

Also, becoming aware of your anger warning signs and triggers is important. For example, does your stomach get tied up in knots when you get angry? If so, when that happens in the future you know you need to take measures to de-stress right then, as you don't want to allow stress hormone levels to continue to rise in your body by remaining angry.

Learning ways to de-stress or cool down when angry and finding healthier ways to deal with your anger are important and include avoiding people, places and situations that bring out your worst, when at all possible. But that isn't always doable. Participating in physical activities that help you get out some of your frustrations while increasing your physical health at the same time, like through exercise, is an excellent way of de-stressing.

But sometimes it isn't a matter of avoiding difficult people or exercising away your anger. Sometimes it is a matter of attempting to find a resolution to a problem with a person, if at all possible. And that's when others may have to be brought in to help resolve an anger issue. After all, your life may be at stake if you don't.

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