With so many responsibilities laid at the feet of women today, keeping everything in check is enough to shorten your fuse. But when chronic stress weighs you down, an angry outburst actually has the potential to trigger a heart attack, stroke, or other cardiovascular episode within two hours of the outburst, according to a recent meta-analysis published in the European Heart Journal by researchers at the Harvard School of Public Health. The absolute risk increased for people who had previous cardiovascular conditions or who were frequently angry.

The study adds to the body of research that links chronic anger, as well as emotional stress and anxiety, to cardiovascular disease and stroke.  Another recent study by psychologists at the University of Pittsburgh, of 157 healthy individuals, found that emotional stressors, such as anger, anxiety, and depression, may actually increase the level of inflammation in the bloodstream and increase the thickness of the heart’s carotid artery wall, a marker for atherosclerosis and heart disease. For women in particular, researchers at the Barbra Streisand Women’s Heart Center at Cedars-Sinai Medical Center found emotional stress and anger may cause changes in the nervous system that controls heart rate and may trigger a type of coronary artery dysfunction.

Before you can fix the problem of anger or emotional stress, and the resulting negative effects on your heart, you have to identify it, says Kristopher Young, M.D., director of Capital Health’s Chest Pain Center in Hopewell.

“Nearly every patient tells me how stressful their job or life is,” says Dr. Young. “Though it’s a complicated topic, stress increases your ‘stress hormones,’ which raises your blood pressure and prevents you from getting good sleep, which are both very important for heart health.”

Dr. Young recommends everyone gets back to the basics: exercise and better sleep.

“Exercise is clearly shown to reduce stress and improve sleep, and therefore your reactions to the daily trials of life,” says Dr. Young. “Most people don’t get enough sleep or enough good sleep. Stress leads to tossing and turning and starts a bad cycle of more stress, less sleep. Our bodies need to rest to get ready for the next day. Poor sleep prevents us from doing our best and ultimately stresses the heart, leading to increase in heart attack and stroke.”

When stressful situations get the best of us, simply walk away says Randi Protter, M.D., medical director for Capital Health’s Center for Women’s Health.  “For moments of high anger, if one has enough insight to recognize the crescendo, a personal timeout can sometimes diffuse the emotion,” she says.

Keeping calm also starts with controlling your personal environment, says Dr. Protter, who suggests using aromatherapy or playing soothing music. Relaxation techniques, including meditation, breathing exercises, and pressure point therapy, have also been shown to be helpful.

If chronic anger has a hold of you, Dr. Protter says you may need counseling. “Objective expert input can be immensely helpful,” she says. “We have a mental health provider list that we give to our patients with stress—anything from life coaches all the way to psychiatrists.”

What shouldn’t you do? Don’t go it alone. A support network of family, friends, and community is essential to getting control over life stressors, says Dr. Protter. “Sometimes talking with a friend can greatly improve a situation,” adds Dr. Young.

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