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Home > Research Articles > Expressing Anger May Protect Against Stroke And Heart Disease

Center for the Advancement of Health

Monday, February 3, 2003

February 3, 2003

(Center for the Advancement of Health) -- Men who outwardly express anger at least some of the time may be doing their health a favor: A new study suggests that occasional anger expression is associated with decreased risk of stroke and coronary heart disease.

Men with moderate levels of anger expression had nearly half the risk of nonfatal heart attacks and a significant reduction in the risk of stroke compared to men with low levels of anger expression. In the case of stroke, the researchers found that the risk decreased in proportion to increasing levels of anger expression.

The findings indicate "a more complex pattern of associations between anger and cardiovascular disease than previously described," according to Patricia Eng, Sc.D., of the Harvard School of Public Health, and colleagues.

"Moderate anger expression seems to be protective against cardiovascular disease over a limited follow-up period," Eng says.

Previous research suggests that chronic anger is related to the development of coronary disease, but few studies examine how different styles of expressing anger might impact the disease, according to the researchers.

The 23,522 study participants, men aged 50 to 85, completed surveys that asked them to rate how often they behaved in certain ways when they were angry, choosing from options like "I argue with others," and "I do things like slam doors." Eng and colleagues also documented 328 cases of cardiovascular disease among the men in the two years following the survey.

Among healthy men with no prior history of cardiovascular disease, the protective effects of anger expression were unrelated to how often the men reported feeling angry. Among men who already had heart disease, however, an increased frequency of angry feelings was significantly associated with an increased risk of another bout of heart disease.

The study participants had low levels of anger expression compared to other groups who had taken the survey previously, possibly due to their age and relatively high socioeconomic status, say the researchers.

Individuals with high socioeconomic status are more likely to lead healthier lifestyles and to be in positions of power where they can express anger freely, which may modify any "potentially toxic effects of anger or hostility," Eng says.

The study is published in the January/February issue of Psychosomatic Medicine and supported by grants from the National Institutes of Health.