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.
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Anger and hostility are associated with increased platelet aggregation and inflammation.
“Anger and hostility are associated with increased platelet aggregation and inflammation. 100”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [100]
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- Authors
- Suls, J.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Suls, Jerry
- ORCID
- Suls, Jerry
- Venue
- Progress in Cardiovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 55
- Issue
- 6
- Pages
- 538-547
- ISSN
- 0033-0620 (ISSN-L)
- OpenAlex
- W2035956126
- Cited by
- 93
- References
- 13
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 6 · 2023: 10 · 2022: 8 · 2021: 7 · 2020: 9 · 2019: 4 · 2018: 5 · 2017: 11 · 2016: 4 · 2015: 14 · 2014: 9
- FWCI
- 6.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Progress in Cardiovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-080241)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- anger, hostility, cardiovascular risk, stress, heart rate variability, platelet aggregation, inflammation, autonomic function, cynicism
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anger, Cardiovascular Diseases, Female, Hostility, Humans, Male, Mental Health, Middle Aged, Prognosis, Risk Factors, Stress, Psychological, Health Behavior
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