"The increased risk of heart attack following intense anger or anxiety is most likely the result of increased heart rate and blood pressure, tightening of blood vessels and increased clotting, all associated with triggering of heart attacks", explained Thomas Buckley, senior lecturer at the University of Sydney, Australia.

The study was an investigation of patients suspected of myocardial infarction (MI, heart attack) and admitted for primary angioplasty at the Royal North Shore Hospital in Sydney, Australia, between 2006 and 2012. It involved 687 participants.

Based on the participants' usual frequency of anger, the risk of heart attack was found to be 8.5 times higher in the two hours following an acute episode of anger than during the usual frequency patterns of anger.

Anger, as evident over the 48 hours preceding the onset of symptoms, was self-assessed by a questionnaire based on a seven-point scale.

The researchers advised that propensity to anger or anxiety should be assessed when managing an individual with heart disease or preventing heart disease in others.

"It should be part of helping individuals to take care of themselves," Buckley noted.

The study appeared in the European Heart Journal; Acute Cardiovascular Care.

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