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Anger report predicts coronary artery vasomotor response to mental stress in atherosclerotic segments
M D Boltwood1, C B Taylor, M B Burke
1Department of Psychiatry, Stanford University School of Medicine, California 94305-5542.
Insights
High anger levels can cause vasoconstriction in narrowed coronary arteries. This study found that recalled anger significantly correlated with decreased arterial diameter in these specific vessels.
Area of Science:
- Cardiology
- Psychophysiology
- Behavioral Medicine
Background:
- Myocardial ischemia is a condition where the heart muscle doesn't receive enough blood.
- Coronary artery vasoconstriction is a narrowing of the arteries that supply blood to the heart.
- The psychological effects of emotions, like anger, on cardiovascular health are of significant interest.
Purpose of the Study:
- To investigate the impact of experimentally induced anger on coronary artery diameter.
- To determine if anger recall influences vasoconstriction in patients with symptomatic myocardial ischemia.
Main Methods:
- 12 patients with symptomatic myocardial ischemia underwent cardiac catheterization.
- During catheterization, patients recalled an anger-inducing event.
- Quantitative angiographic techniques and self-report measures assessed arterial diameter and anger levels.
Main Results:
- Anger recall significantly increased self-reported anger and arousal.
- No significant changes were observed in heart rate or blood pressure.
- A significant correlation was found between high anger levels and decreased diameter in narrowed coronary arteries (vasoconstriction).
Conclusions:
- Anger can induce coronary artery vasoconstriction, particularly in previously narrowed arteries.
- The effect appears to be dose-dependent, occurring primarily with high levels of anger.
- These findings suggest a link between emotional stress and acute coronary events in susceptible individuals.
Abstract:
To determine the effects of anger on coronary artery vasoconstriction, 12 patients with symptomatic myocardial ischemia were studied during cardiac catheterization. During catheterization, the patients were asked to recall a recent event that had produced anger. One narrowed and 2 non-narrowed arterial segments were selected using predetermined criteria. Patients also completed various self-report measurements upon entering the catheterization laboratory before any procedures, after completion of the clinical angiogram and after the anger recall stressor. There was a significant increase in subject reports of anger (F[1,6] = 21.94, p < 0.01) and arousal (F [2,6] = 5.49, p < 0.05) during the anger stressor. There were no significant changes in heart rate, systolic or diastolic blood pressure, or heart rate x systolic blood pressure product during the anger stressor. A total of 27 arterial segments (9 narrowed and 18 non-narrowed) were selected and analyzed using quantitative angiographic techniques. Repeated-measures analysis of variance (baseline vs anger stressor) found no significant group differences with regard to changes in arterial diameter between conditions or among segments. Reported anger was significantly correlated with a decrease in both mean (r = -0.76, p < 0.05) and minimal (r = -0.82, p < 0.05) diameter changes in narrowed arteries. Vasoconstriction only occurred with high levels of anger. There were no significant correlations between anger report and diameter change in non-narrowed arteries. Thus, anger may produce coronary vasoconstriction in previously narrowed coronary arteries.