Here’s something to feed your guilt: The old saw about giving someone a heart attack because of your bad behavior might actually have legs, as it turns out — if your behavior evokes anger in the “victim.” According to a new study out of Yale University, anger triggers abnormal heart rhythms that can lead to sudden heart attack. The researchers followed 62 patients who already had heart disease and who wore implanted defibrillators, which detect when heart rhythms becomes irregular or stop. Defibrillators send tiny electric shocks into the heart when they detect such arrhythmia in order to restore normal heartbeat and prevent cardiac arrest.

The researchers worked to evoke anger in the subjects by asking them to relive an infuriating situation, posing questions designed to make their anger escalate (sometimes you’ve got to wonder what, beyond science, motivates scientists). Meanwhile, the researchers measured patient response via an EKG. As it turns out, when subjects just thought about the irritating event, it raised their ire to the point that, in fact, they did experience irregular heart rhythm. Lead researcher Dr. Rachel Lampert explains, “Anger causes electrical changes in the heart. That means [patients are] more likely to have arrhythmias when they go out in real life.”

Sure enough, those subjects who showed the most dramatic anger response in the EKG were ten times more likely to have their defibrillator fire to save their lives within the next three years. In other words, without the defibrillator, they’d be 10 times more likely to suffer a sudden heart attack. But Dr. Lampert says the effect might be different in people who don’t have preexisting heart problems. “How anger and stress may impact people whose hearts are normal is likely very different from how it may impact the heart which has structural abnormalities,” she said. Or not!

In any event, the results have researchers thinking that in the future, a mental stress test should be added to the routine physical stress test that doctors administer to test cardiac function. And, Dr. Lampert is continuing his study to test the effects of anger management training on cardiac function in patients.

Earlier studies also found a link between anger and heart problems, although much of the earlier research focused on the long-term deleterious effects of anger. One 2003 study of 800 women with heart problems who measured high on hostility scales found that the most hostile subjects were twice as likely to die from heart problems as were the more serene subjects. The startling finding in that study was that hostility posed more cardiovascular risk than did hypertension, high cholesterol, and smoking. And a 20-year longitudinal study started at Duke University in 1990 followed students who measured high on hostility scales and found that those subjects tended to have higher levels of “bad cholesterol” and health-threatening lifestyle behaviors later in life. A complementary study at Yale found that subjects who measured high on emotional responsiveness scales in youth were three times more likely to die of cardiac arrest later on than were even-tempered subjects.

In any event, it’s clear that emotional balance protects the heart and prolongs life. (Heck, I devoted an entire chapter in Lessons from the Miracle Doctors to exactly that issue.) And so, it sure makes sense to spend time enjoying yoga, meditation, tai chi, cardiovascular exercise, psychotherapy, massage — or whatever keeps you on an even keel. If these avenues don’t work for you, check out emotional freedom technique (EFT), neurofeedback, or even brain-wave regulating music. Or you can just go out and buy a StressEraser. These things really do work, if you practice regularly. And remember to take antioxidants, protective methylating supplements, and Omega-3 fatty acids to undo any damage suffered in spite of your best efforts to remain serene as a saint.

:hc