The Enraged Heart (3/11/14)
Does Anger Kill?
For thousands of years the anecdotal answer has been yes. Rage frequently kills those enraged – and those around them. But what happens in modern life?
Therein’s a tale involving personality, tobacco, and the changing mores of research.
What’s New Now?
A large meta-analysis in the European Heart Journal, put together by Elizabeth Mostofsky and colleagues. Picking through what they consider to be reasonably believable data, the group comes up with these numbers: a five fold increase in heart attack in the two hours following an angry outburst, a three fold increase in stroke.
Are These Numbers Believable?
Probably. The group has done plenty of studies themselves, and their own numbers run pretty close.
How Significant is the Problem?
Depends on how angry you are – and the overall risk profile for your heart. For people with “low cardiac risk,” one angry outburst per month increases risk of heart attack to about 1 per 10,000 people. But if you are really angry – five outbursts or more a month – the risks are much higher.
How Much of This is Due to Personality?
Do you consider yourself type “A” – driven, controlled by the clock, striving, productivity oriented, impelled by a series of self-declared rules? Or are you the “opposite” – the real laidback type “B?”
After Meyer Friedman and Ray Rosenman developed the Type A – Type B concept in the 1950s, it really took off in the public mind. Many corporate and political leaders declared themselves type A. But they were told they faced a price – more heart disease.
Study after study by Friedman and Rosenman demonstrated greater heart disease and death to the hard charging type A. A rather large consulting business developed to “calm” type As so they might not rush to the cemeteries.
But other epidemiologists could not replicate these results. One prominent heart epidemiologist told my in the 1980s “it turned out that what determined who was Type A and who Type B was an interview with Ray Rosenman.” When operational criteria – reliable, consistent, testable definitions – were developed by Jenkins and others, type Bs appeared to die quicker than type As.
But what was Rosenman picking up?
Redford Williams, who wrote “Anger Kills” and has done much behavioral research on the heart, found that a subgroup of Type As were dying before their time. The traits associated with increased death were hostility and anger. Other “Type A” traits did not seem to shorten lifespan. Williams’ further argued that suppressed hostility was perhaps worse than the directed kind. Now the arguments have shifted.
Anger itself appears bad for the heart.
But Rosenman and Friedman fought hard to have their interpretations accepted. To them, Type A was a major risk factor for death. And their research backers turned out – much of the time – to be tobacco companies.
Big tobacco recognized that “muddying the waters” would help them in the courts. Were cigarettes killing people – or was it their personalities, their type A behaviors? When it comes to giant class action suits, doubt is a very handy thing to have in the docket.
So What Do You Do With Anger?
Humans possess many emotions. Many of them may appear – or erupt – simultaneously.
Yet expressions of anger often provoke more anger –especially from others. Arguments get out of control. Drugs interdict inhibition.
An angry alcoholic may do more than risk her heart health. If she drives, or wields a gun, that may prove dangerous for family members and friends – and passersby. Nor does that problem begin to include associated risks: suicide; long term collateral damage to families; the economic costs of thwarted dreams and disrupted lives; the cultural damage inflicted by an angrier population. In many different forms and formats, anger may kill.
The main treatment for individuals who are often angry is behavioral. They can be as varied as the thousands of rest and relaxation techniques civilizations create; walking and hiking in nature; meditating and performing yoga. The number of behavioral treatments includes a very long list.
Yet medications also have some place. Freud taught that depression was “anger turned inward.” Clinical studies find the opposite. Perhaps half of depressed people are angry – often very angry. People suffering from bipolar illness often complain of intermittent explosions of fury that may be provoked by “practically nothing.”
For moodiness and anger are linked.
So anger is closely linked to mortality. Controlling it has many benefits – for individuals and populations.
And for both their literal and metaphorical hearts.
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