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Get mad -- it's good for you

A new study finds that women who hold in hostility may face increased risk of stroke

Thursday, September 24, 1998

By Anita Srikameswaran, Post-Gazette Staff Writer

If she is woman, and you hear her roar, then chances are she doesn't have clogged arteries.

Researchers are finding that women who hide their angry feelings from others tend to have thickened carotid arteries of the neck, increasing the risk of stroke and other cardiovascular disease in later life.

A study published in this month's issue of the journal Psychosomatic Medicine is the first to closely examine the relationship between anger and cardiovascular disease in women.

University of Pittsburgh psychologist Karen Matthews, who led the study, said holding anger may be a unique risk factor for women, whereas previous studies have shown that men at risk express their anger frequently.

Women who had hostile attitudes or were very self-conscious in public also had a greater likelihood of thickened neck arteries.

The condition of the arteries was determined by ultrasound techniques that are usually used in older people who have had strokes.

The new findings come from a large study of the biological and behavioral changes of menopause. In 1983, women participating in the study completed standard surveys about anger and anxiety. The surveys asked them to respond to statements like "people around me wouldn't know if I was angry or upset."

All the women were between 42 and 50 years old, pre-menopausal and healthy.

In 1993, 200 of the women who had been menopausal for at least five years were offered the ultrasound artery assessment. Factors such as smoking, blood pressure, hormone replacement therapy and triglyceride levels, which are a measure of fat in blood, were taken into account prior to concluding that the behaviors were related to cardiovascular disease risk.

Researchers are investigating how aspects of personality are related to physical markers of disease such as a fat plaque in an artery.

One theory suggests that people who experience a lot of negative emotions may be less able than other people to fine tune their heart-rate response to everyday events, which might be a risk factor, Matthews said. Another possibility is that people who are frequently stressed through the day recurrently produce high levels of hormones that in turn elevate blood pressure and heart rate.

Some studies have found that people who have large blood pressure changes when they are stressed may be at a greater risk for clogged arteries, said Pitt psychologist Thomas Kamarck. His research lies in exploring this so-called "reactivity hypothesis," which states that people who have greater swings in blood pressure and heart rate when stressed may be at increased risk for developing coronary artery disease.

Known risk factors for cardiovascular disease, such as high cholesterol and elevated blood pressure, should not be minimized.

"Stress and emotional expression are part of the picture, but I think we would be over-reaching to say they are the largest piece," Kamarck said. "If you had a choice to quit smoking or practice stress management, you would be better off quitting smoking."

Stress modification through relaxation techniques and developing closer relationships with others can be beneficial, he added.

What would Matthews advise her daughter about dealing with anger?

"It's better to express it in a constructive way and change things," she said. "In the long run, (holding anger in) is not going to work for mental or physical health."



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