By Chioma Umeha
A study has shown that both intense activity and
emotions increases the risk of suffering a heart attack within an hour.
An online report of the new research said Tuesday
that intense anger or heavy physical exertion may be triggers for a first heart
attack in some people.
Regular exercise is a healthy antidote to stress
and can help prevent heart disease – the biggest problem is that too many
people get too little of it.
But, the new research suggests there may be better
or worse times t
“This study is further evidence of the connection
between mind and body. When you are angry, that is not the time to go out and
chop a stack of wood,” said Barry Jacobs, a psychologist at the Crozer-Keystone
Health System in suburban Philadelphia and an American Heart Association
volunteer.
He had no role in the study , led by the
Population Health Research Institute at McMaster University in Hamilton,
Ontario. Results were published Monday in the Heart Association journal
Circulation.
Earlier studies have looked at anger and exertion
as heart attack triggers but most were small or in one country, or included few
women or minorities. The new study involved 12,461 people suffering a first
heart attack in 52 countries. Their average age was 58 and three-fourths were
men.
They answered a survey about whether they were
angry or upset, or had heavy exertion, in the hour before their heart attack or
during the same time period the previous day. That way researchers could
compare risk at different times in the same people and the effect of these
potential heart attack triggers.
Being angry or upset doubled the risk of suffering
heart attack symptoms within an hour; heavy physical exertion did the same.
Having both at the same time more than tripled the risk for a heart attack.
The risk was greatest between 6 p.m. and midnight,
and was independent of other factors such as smoking, high blood pressure or
obesity.
Caution: Patients reported their own stress or
anger, and people who just had a heart attack may be more prone to recall or
think they suffered one of these triggers than they otherwise might have been.
Also, strenuous exertion is whatever the patient perceives it to be – for some
people that could be climbing stairs and for others, running a marathon.
The study also is observational, so it cannot
prove cause and effect. But it is likely to be the best kind of information
available – it is not possible to randomly assign people to be angry and
exercise, then see how many have heart attacks.
“This is a large enough sample size that we can
put stock in the findings,” Jacobs said.
“We all need to find ways of modifying our
emotional reactions and to avoid extreme anger,” such as distracting ourselves,
walking away from the stressful situation, trying to see it from a different
perspective, talking it out and getting support from other people, he said.
The study’s findings also are biologically
plausible. Emotional stress and exertion can raise blood pressure and heart
rate, change the flow of blood in the vessels and reduce the heart’s blood
supply, said the study leader, Dr. Andrew Smyth of McMaster University. In an
artery already clogged with plaque, a trigger could block blood flow and lead
to a heart attack.
“From a practical perspective, there will be times
when exposure to such extremes is unavoidable,” Smyth said.
“We continue to advise regular physical activity
for all, including those who use exercise to relieve stress,” but people should
not go beyond their usual routine at such times, he said.
The study was funded by the Canadian Institutes of
Health Research, other governmental bodies from various countries that
participated, and grants from several drug companies.
