If you’re angry or upset, you might want
to simmer down before heading out for an intense run or gym workout. A
large international study ties heavy exertion while stressed or mad to a
tripled risk of having a heart attack within an hour.
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 to
exercise, and that extremes can trigger harm.
“This study is further evidence of the
connection between mind and body. When you’re angry, that’s 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. 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.
Big
caveats: 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 is also
observational, so it cannot prove cause and effect. But it’s likely to
be the best information available – it’s 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 are also 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. 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.
No comments:
Post a Comment