Suppressed Anger in CAD Linked to Adverse Cardiac Events

Suppressed anger associated with greater risk of myocardial infarction, cardiac death
By Eric Metcalf
HealthDay Reporter

THURSDAY, June 10 (HealthDay News) -- In patients with coronary artery disease (CAD), suppressing anger is associated with a higher risk of adverse cardiac events, according to research published in the June 1 issue of the American Journal of Cardiology.

Johan Denollet, Ph.D., of Tilburg University in the Netherlands, and colleagues analyzed data from 581 men and 63 women with CAD (mean age, 55.8 years). Participants completed assessments of anger and personality at baseline, and were followed for an average of 6.3 years for major adverse cardiac events and cardiac death or myocardial infarction.

The researchers found that suppressed anger was associated with a higher risk of cardiac death or myocardial infarction (odds ratio, 2.87) after controlling for several factors, including extent of CAD and revascularization. Subjects with Type D personality -- marked by a tendency to experience distress and be inhibited -- had a four-fold rate of suppressed anger. Individual differences in Type D personality appeared to account for the link between suppressed anger and cardiac prognosis.

"Although patients who deliberately and habitually inhibit the outward expression of anger might appear unaggressive, they might actually experience high levels of anger. In these patients, emotional suppression could also impede effective cardiac care," the authors write. "The findings of the present study have clearly indicated that patients with CAD who tend to suppress their anger represent a vulnerable group that should be closely monitored and, when needed, offered additional clinical care."

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