Episode of anger increases risk of heart attack 4… ABC do ABC

You may have heard that being angry is bad for your health. A study published this week in Journal of the American Heart Association suggests that this is not legend. According to the survey, brief episodes of irritation can cause immediate dysfunction in blood vessels, increasing vulnerability to heart attacks It is spills.

The researchers evaluated 280 adults divided into four groups: one of them was instructed to recall a personal memory that caused irritation, the other to recall a situation that caused anxiety. The third set had to say phrases evoking sadness, while the fourth repeatedly counted to 100 to induce an emotionally neutral state.

The analysis of the blood vessels was carried out before the tasks and then, after three, 40, 70 and one hundred minutes from the beginning of the experiment, using a device that analyzes the structure of the vessels in the fingertips (similar in appearance to that of an oximeter), explains the cardiologist Aurora Issadirector of the National Institute of Cardiology of the Ministry of Health.

“The study showed that, after 40 minutes, people subjected to angry memories had losses in the dilation of blood vessels, a fundamental mechanism for the good performance of the cardiovascular system. Although this dysfunction lasted for a short time, the hypothesis is that this effect could generate long-term complications if it occurs frequently”, says Issa.

The main structure compromised by the feeling of anger was the endothelium, which lines the internal surface of the vessels. This tissue produces and releases important substances for vascular contraction and relaxation, managing blood flow, explains the cardiologist Carlos Henrique Rassi, coordinator of the Cardiology Center at Hospital Sírio-Libanês in Brasília. The imbalance of these functions favors the accumulation of fat in the arteries, thrombosis, hypertension, inflammation, ischemia and other complications.

Dysfunction in the endothelium was identified only in the anger-induced group, surprising the medical community, which also expected to find harm in patients subjected to sadness. The reason for the difference is not yet known, but one hypothesis is that cardiac performance decreases when you are sad, generating less vascular contraction than irritation and less damage to the tissue, says cardiologist Fernando Costa, from Beneficência Portuguesa in São Paul.

“Relationships between mental state and cardiovascular health have been studied for decades and, although the new research brings insights into the mechanism of this interaction, analyzes with larger populations still need to be done for anything to change in the clinical protocol”, says the cardiologist Luciano Ceolin Rosa, technical director of the Rio Grande do Sul Cardiology Institute.

The cultural factor is among the biases in the research, says cardiologist Antônio Aurélio Fagundes Juniorresearcher at Idor (Institute D’Or for Research and Teaching). “There are more or less emotional people and the perception of anger or sadness can vary depending on the culture”, exemplifies.

The expectation is that science will continue to consolidate a field that has been promoted since the 1990s with epidemiological studies. One of the most recent, published in 2020 in the journal Psychological Medicine, investigated the impacts of screening, diagnosis and treatment of depression on the incidence of cardiac events. Research has found that monitoring the mental health of patients with acute coronary syndromes and appropriately treating depression can improve long-term cardiac outcomes.

In 2022, the The American Journal of Medicine published a review on the topic, pointing out that there is an increased risk of cardiovascular problems among stressed patients, although this is not as strong a risk factor as diabetes or smoking.

In April, during the annual meeting of the American College of Cardiology, Brazilian cardiologist Maria Emília Teixeira, from UFG (Federal University of Goiás) presented results from a study with one hundred people indicating that contact with WhatsApp messages evoking forgiveness and feelings of joy helped reduce the pressure of hypertensive patients.

Also following this line, the SBC (Brazilian Society of Cardiology) launched a group to debate the relationship between cardiovascular health and mental health. “We increasingly see the importance of embracing patients as a whole. In cardiology, this view only tends to gain strength”, says the cardiologist Nivaldo Filgueiras, member of the SBC Administrative Council.