NEW YORK (Reuters Health) - Hot-tempered men are more likely to develop premature heart disease and suffer an early heart attack compared with their more placid peers, study findings indicate.

The study of more than 1,000 men found that those who responded to stressful situations with feelings of anger and irritability were three times more likely to be diagnosed with heart disease before they turned 55. These men were also five times as likely to have a heart attack before the age of 55.

"The findings suggest that learning to control anger might reduce the risk of premature heart disease, the leading cause of death in the US," Dr. Patricia P. Chang, the study's lead author, said in a prepared statement. About 15% of deaths from heart disease occur before the age of 55, note researchers in the April 22nd issue of the Archives of Internal Medicine.

"The most important thing angry young men can do is get professional help to manage their tempers, especially since previous studies have shown that those who already have heart disease get better with anger management," explained Chang, of The Johns Hopkins University in Baltimore, Maryland.

The study volunteers, who graduated from medical school between 1948 and 1964, received an initial medical exam and answered questions about their medical history, health behaviors and reactions to stress. Every 5 years, the group completed a questionnaire in which they provided information about their health and checked a box next to phrases that described how they respond under pressure.

In 1995, when the average age of the group was nearly 65 years, about 8% had been diagnosed with premature heart disease. Men who reported that they became irritable, expressed their anger, felt angry but concealed the emotion, and participated in gripe sessions had a higher risk of premature heart disease and heart attack, compared with men who were less angry, regardless of cholesterol levels, body mass index (BMI) and blood pressure.

Anger was also found to raise the risk of depression and anxiety but was not associated with an increased risk of premature stroke, the results indicate.

Exactly how anger can lead to cardiovascular problems is not clear but the researchers note that anger is associated with the release of catecholamines--compounds that constrict blood vessels, increase heart rate and boost blood pressure.

"The present study isolates the powerful effect of a high level of anger in young men on subsequent incidence of premature (heart disease)," Chang and colleagues conclude.

SOURCE: Archives of Internal Medicine 2002;162:901-906.

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