title: Anger and the heart: perspectives on cardiac risk, mechanisms and interventions.
abstract: In the popular imagination, anger has long been linked to cardiovascular diseases (CVD), but empirical validation from case-control and prospective studies emerged only in the 1970's. After describing the multidimensional nature of anger and its assessment (via self-report or observed in structured interviews), this paper selectively reviews evidence in (a) behavioral epidemiology, (b) stress and biological processes with implications for cardiopathogenesis, and (c) behavioral/pharmacological interventions for anger/hostility reduction. Although evidence is inconsistent, chronic feelings of anger, cynical distrust and antagonistic behavior are at least modestly associated with risk of both initiation and progression of CVD. Anger/hostility also is linked to stress exposure and reactivity, exaggerated autonomic function, reduced heart rate variability, platelet aggregation and inflammation. Clinical and pharmacologic treatment of anger/hostility has the potential to reduce anger and its health-damaging effects. Limitations, including third-variable explanations and overlap among the negative emotions, and implications for cardiology and behavioral medicine research and practice are discussed.
authors.affiliation: Department of Psychology, University of Iowa, Iowa City, IA 52242, USA. jerry-suls@uiowa.edu
authors.forename: Jerry
authors.initials: J
authors.lastname: Suls
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D005260:Female; D015438:Health Behavior; D006791:Hostility; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology