Prone to blowing up? You might want to rein it in. A new study says getting mad even briefly causes blood vessels to contract, which raises blood pressure and increases the risk of a heart attack or stroke.

In the Columbia University-led study, published in the Journal of the American Heart Association, 280 adult volunteers were randomly assigned to different eight-minute experiences that create one of three emotions: anger, anxiety or sadness. In the control, neutral emotion group, participants were told to count to 100 over and over for the duration of the experiment.

Only anger provoked that physical response.

It’s not entirely surprising, researchers told Medical News Today, which noted that “‘raising one’s blood pressure” is an idiom for getting mad.

The researchers measured each volunteer’s blood vessel dilation, ability to repair cells and other cellular function before, during and after the emotion-provoking experience. Those who were angry had contracted blood vessels for up to 40 minutes after the emotion was experienced. In a news release, the American Heart Association said that when the blood vessel’s ability to relax is impaired, it can cause atherosclerosis, which can increase the risk of heart disease and stroke.

Atherosclerosis is thickening or hardening of the arteries, caused by plaques buildup in the artery, per Johns Hopkins Medicine. High blood pressure is one of the risk factors.

“Impaired vascular function is linked to an increased risk of heart attack and stroke,” said lead study author Dr. Daichi Shimbo, professor of medicine at the Columbia University Irving Medical Center in New York City. “Observational studies have linked feelings of negative emotions with having a heart attack or other cardiovascular disease events. The most common negative emotion studied is anger, and there are fewer studies on anxiety and sadness, which have also been linked to heart attack risk.”

Shimbo said that studying why anger changes blood vessel function could help target treatments for those at higher risk of cardiovascular events.

“This study adds nicely to the growing evidence base that mental well-being can affect cardiovascular health and that intense acute emotional states, such as anger or stress, may lead to cardiovascular events,” said Dr. Glenn Levine, professor of medicine at Baylor College of Medicine and chief of cardiology at the Michael E. DeBakey VA Medical Center, both in Houston, who was quoted in the news release.

“For instance, we know that intense sadness or similar emotions are a common trigger for Takatsubo cardiomyopathy, and events such as earthquakes or even as a fan watching a world soccer match, which provoke stress, may lead to myocardial infarction and/or to arrhythmias. This current study very eloquently shows how anger can negatively impact vascular endothelial health and function, and we know the vascular endothelium, the lining of blood vessels, is a key player in myocardial ischemia and atherosclerotic heart disease,” Levine said.

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Dr. Holly Middlekauff, a cardiologist and a professor of medicine and physiology at UCLA’s David Geffen School of Medicine who wasn’t part of the study, told NBC News that the study could help doctors persuade patients with heart disease and anger issues to find tools to manage their anger. She suggested yoga, exercise, cognitive behavior therapy or other established techniques could help.

“It’s not widely known or widely accepted that anger does precipitate heart attacks,” she said. “This study offers a biological plausibility to that theory, that anger is bad for you, that it raises your blood pressure, that we’re seeing impaired vascular health.”

Study nuts and bolts

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The team of researchers came from Columbia University Irving Medical Center, Yale School of Medicine and St. John’s University.

The study participants averaged 26 years of age and had no history of heart-related problems, Type 2 diabetes or a self-reported mental health disorder. They were not taking prescription medication or nutritional supplements. And they were not smokers.

Before the emotional tasks, they were seated comfortably and told to simply relax for a half-hour, but were told not to talk, use their phones, read anything or nap. Then their blood pressure and heart rate were measured, as was blood pressure dilate. Blood samples were taken. Measures were also taken after the emotional task at certain points: three minutes, 40 minutes, 70 minutes and 100 minutes.

The researchers noted several study limitations, including that the participants were young and apparently healthy, so it’s not clear if the findings would be the same for older adults, who might also be taking medications. The study was also conducted in a medical setting, not out in the real world. And only short-term effects of the emotions were examined.

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