In the 1980s, doctors often suggested that waving your anger like a flag was good for the head and cleansing for the soul.
Now, though, the advice is changing: Some recent scientific studies have shown that venting hostility can stir up stress hormones in your body in a way that, ultimately, could damage your heart.
A study by Dr. Murray Mittleman and his colleagues at Harvard Medical School - published last month in the journal Circulation - suggests, for instance, that an angry outburst can more than double the risk of a heart attack in some people.
And Dr. Redford Williams of Duke University - who has been studying about 100 lawyers for decades in an ongoing look at stress - has found that the attorneys who said their anger levels were high in their years as students were four to five times more likely to die in their 50s than their somewhat calmer colleagues.
Richard Friedman, a professor of psychiatry at the State University of New York at Stony Brook and director of research at the MindBody Medical Institute at Harvard, said these studies and others leave “little doubt” that episodes of anger are dangerous.
“The notion that letting it out is protective,” he said, “is not borne out in science.”
Once a volcanic kind of guy himself, Williams, who wrote “Anger Kills,” said he has learned to ask questions about his anger, and now lets steam out in less explosive ways.
“You have to effectively understand your feelings,” he says, “and find a means of calming yourself down.”
The link between anger and your heart is a complicated one, researchers say.
Last year, scientists at the University of Pittsburgh said they discovered that stress increases the stickiness of blood platelets, the cells that help blood clot following a cut.
When stress is high, the researchers found, the body pumps out extra adrenaline, which interacts with blood platelets, making them stickier - probably in anticipation that whatever is causing the stress could eventually result in an injury. In turn, the sticky platelets latch on to fatty deposits already lurking about in the arteries, increasing the risk of heart disease.
Friedman, a behavioral psychologist, said he shares this information with his patients, telling them that when they’re angry, they should ask themselves: “Is this really worth sticky platelets?”
“It makes people laugh,” Friedman says. “But it works.”
At Duke, Williams has studied the long-term effects of hostility for years, but now is also trying to determine the day-by-day events that contribute to heart disease.
For one thing, he says he’s finding that blood pressure goes up when people are exposed to violence - not just to the real-life kind that’s known to cause fight-or-flight hormones to surge, but also to Rambo-style movies.
Williams has men and women watch violent and nonviolent clips from movies - “Sleeping With the Enemy,” for instance, and “Falling Down” - while hooking them up to blood pressure cuffs and other monitoring devices. The scientists also drew blood to test stress hormone levels.
With violence, blood pressure moves up two to six millimeters. What’s more, the dose of violence triggers a higher blood pressure surge when an on-screen argument turns into an arm-swinging wrestle.
These cardiovascular changes occur only when people are watching violence carried out by someone of the same sex, suggesting that they identify more with the character.
Heart rate went up, but it didn’t vary with gender. And women also had higher surges of the stress hormone, cortisol.
“When you consider how many people watch a movie, and half the population watching it are having a rise in blood pressure, it is important to worry.
Over time, that cumulative extra workload could be contributing to an increased risk for cardiovascular disease,” Williams said.
He points out that the rise in blood pressure may seem insignificant, but doctors prescribe blood-pressure-lowering drugs to reduce the pressure by three millimeters or less, “and that is associated with decrease in mortality rate.”
Almost 30 percent of the adult population has blood pressure levels higher than normal.
Dr. Gail Ironson of the University of Miami found that cardiovascular patients who simply re-live an anger-producing episode suffered a 5 percent to 7 percent drop in the heart’s pumping efficacy.
Also, Brown University researchers recently injected fats directly into the bloodstream of 64 middle-aged men and found that the hostile, hot-headed ones took much longer to clear out the fat.
Catherine Stoney, a professor of psychiatry and human behavior, said that this slower clearance rate could increase cholesterol and one’s risk of heart disease.
Some scientists, including Mittleman of Harvard, now believe that anger could be as important a predictor for heart disease as any physical indicator - including smoking or obesity.