Persistent anger can harm people's health, especially as we age
The idea that emotions affect physical health is supported by good deal of evidence.
Persistent anger, anxiety, and/or depression are all linked to chronic inflammation and the major diseases it promotes.
Depression may be the worst heart-health risk, raising the risk of cardiovascular disease (CVD), heart attacks, and other adverse outcomes even more than anger or anxiety can.
And there are clear, mutually reinforcing links between negative emotions and pain, such as those seen among rheumatoid arthritis patients (Graham-Engeland JAE, 2018).
Also, persistent negative emotions like anger promote chronic inflammation, unhealthful stress, and platelet aggregation, which promotes dangerous blood clotting.
Based on the best evidence, a 2018 National Institutes of Health (NIH) report linked better emotional well-being to a nearly 20% drop in the risk of death from all causes.
The NIH report also found that a sense of purpose cuts the risk of heart attack and stroke by about 17% — and that older adults who enjoy mostly positive emotions are 36% less likely to develop mobility problems.
Furniture led to first hard evidence
The link between negative emotions and chronic disease first appeared in the mid-1950s, when a furniture repairman noticed something odd about the upholstered chairs in cardiologist Meyer Friedman’s waiting room.
He alerted Dr. Friedman to unusual wear patterns that looked as though his patients were obsessively rubbing the fronts of the armrests and sitting on the edge of their seats.
That observation led Dr. Friedman and his cardiology practice partner to probe whether people with heart disease might display particular behavior patterns.
Their landmark study revealed that heart disease was twice as common among people who were always in a rush and tended to be generally hostile and more easily angered — emotions that they may not express openly (Friedman M, Rosenman RH 1959).
Friedman and his partner labeled this prickly, driven behavior pattern Type A, and labeled a more relaxed (and common) behavior pattern Type B.
Painting a more nuanced picture
Following this furniture-driven discovery, other research revealed mixed emotional behavior patterns, and more nuanced links between emotional behavior patterns and health.
For example, how well people cope with stress may be a more critical factor. And while people with Type A behavior patterns are more prone to heart attacks, they also appear to survive them at higher rates.
When University of Iowa researchers reviewed the evidence available several years ago, they confirmed modest but substantial links between chronic anger, distrust, or hostility and higher risks for cardiovascular disease (Suls J 2013).
Now, the results of a recent Canadian-German study suggest that ongoing feelings of anger could damage physical health more than persistent sadness, especially among older adults.
Canadian-German study links relentless anger to higher heart risks
The results of a study in older adults link chronic anger to chronic inflammation and suffering from more chronic disease.
The new research comes from Montréal’s Concordia University and Germany’s University of Leipzig and was led by Concordia psychologist Meaghan Barlow (Barlow MA et al. 2019).
For their study, Dr. Barlow’s team analyzed survey answers and blood data from 226 Canadian adults aged between 59 and 93 years.
The surveys asked the participants how angry or sad they felt, and about any chronic medical conditions they had. In addition, the participants submitted blood samples that were tested for markers of inflammation.
To reveal any age-related differences, the participants were divided into two groups:
- Early old age: participants aged 59 to 79 years
- Advanced old age: participants aged 80 years old or older
After comparing the participants’ survey answers and blood tests, the researchers linked ongoing anger to higher levels of a key marker of inflammation called IL6 and to having more chronic illness.
However, this link only applied to persistently angry people in the “advanced old age” group, who were aged 80 years or older. And their analysis showed no link between ongoing anger and blood levels of another inflammation marker called CRP (C-reactive protein).
As study co-author Carsten Wrosch of Concordia University said, “We found that experiencing anger daily was related to higher levels of inflammation and chronic illness for people 80 years old and older, but not for younger seniors. Sadness, on the other hand, was not related to inflammation or chronic illness.”
Because it may take years or decades to suffer noticeable damage health, it makes sense for young and middle-aged people to learn how to cope with stress and negative emotions: for more on that, see "Ways to ease harmful emotions", below.
Anger can play different roles at different ages
Dr. Barlow observed that transitory anger can be a motivational and health ally.
As she said, “Anger is an energizing emotion that can help motivate people to pursue life goals. Younger seniors may be able to use that anger as fuel to overcome life's challenges and emerging age-related losses and that can keep them healthier.”
But she contrasted these potential benefits of transitory anger with the emotion's less fruitful sources later in life: “As most people age, they simply cannot do the activities they once did, or they may experience the loss of a spouse or a decline in their physical mobility and they can become angry.”
In other words, temporary triggers to anger can motivate positive change, while ongoing miseries can promote chronic, health-damaging anger.
Ways to ease harmful emotions
The American Academy of Family Physicians (AAFP) says that emotional health rests on managing inevitable negative feelings like anger, rather than trying to feel happy all the time.
Dr. Barlow and her colleagues noted that education and therapy can help people cope with stress and thus ease negative emotions like anger.
As she said, “... we can teach [older people] how to cope with loss in a healthy way. This may help them let go of their anger.”
And in Emotional Denial Damages Mind & Body, we reported on three clinical trials that each detected health benefits when people acknowledged and accepted negative emotions without dwelling on them.
Cognitive therapy can be an effective aid, and there's good evidence that meditation can help people manage their emotions and reduce mood-related inflammation: see Can Meditation Yield Lasting Calm? and Meditation May Cut Inflammation.
Optimizing your diet and lifestyle early is a proven way to reduce the risk of chronic heart and metabolic diseases.
As Australian researchers reported three years ago, "... low omega-3 [blood] levels have been associated with ... disorders such as poor cognition, depression, anxiety disorders, poor anger control, attention deficit hyperactivity disorder (ADHD) and accelerated neurodegeneration in the elderly." (Grant R and Guest J 2016)
We reported on related research in Fish Oil Aids Hearts by Easing Stress, which reached this conclusion: “... [omega-3-rich] fish oil may have positive health benefits regarding neural cardiovascular control in humans and suggest important physiological interactions between fish oil and psychological stress ...”. (Carter JR et al. 2013)
And it makes sense to learn stress-coping lessons as early as possible, to avoid the cumulative damage caused by years or decades of simmering anger, resentment, or hostility.
- American Academy of Family Physicians (AAFP). Mental Health: Keeping Your Emotional Health. Accessed at https://familydoctor.org/mental-health-keeping-your-emotional-health/
- American Psychological Association (APA). Anger More Harmful to Health of Older Adults Than Sadness. Accessed at https://www.apa.org/news/press/releases/2019/05/anger-harmful-older-adults
- Barlow MA et al. Is Anger, but Not Sadness, Associated with Chronic Inflammation and Illness in Older Adulthood? Psychology and Aging, Vol 34(3), May 2019, 330—340. Accessed at https://www.apa.org/pubs/journals/releases/pag—pag0000348.pdf
- Brod S, Rattazzi L, Piras G, D'Acquisto F. 'As above, so below' examining the interplay between emotion and the immune system. Immunology. 2014 Nov;143(3):311-8. doi: 10.1111/imm.12341. Review.
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- Friedman M, Rosenman RH. Association of specific overt behavior pattern with blood and cardiovascular findings; blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease. J Am Med Assoc. 1959 Mar 21;169(12):1286-96.
- Graham-Engeland JEG et al. Emotional State Can Affect Inflammatory Responses to Pain Among Rheumatoid Arthritis Patients: Preliminary Findings. Psychological Reports. September 6, 2018. Accessed at https://journals.sagepub.com/doi/10.1177/0033294118796655
- Grant R, Guest J. Role of Omega-3 PUFAs in Neurobiological Health. Adv Neurobiol. 2016;12:247-74. doi: 10.1007/978-3-319-28383-8_13. Review.
- Haukkala A, Konttinen H, Laatikainen T, Kawachi I, Uutela A. Hostility, anger control, and anger expression as predictors of cardiovascular disease. Psychosom Med. 2010 Jul;72(6):556-62. doi: 10.1097/PSY.0b013e3181dbab87. Epub 2010 Apr 21
- Möller J, Hallqvist J, Diderichsen F, Theorell T, Reuterwall C, Ahlbom A. Do episodes of anger trigger myocardial infarction? A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP). Psychosom Med. 1999 Nov-Dec;61(6):842-9.
- Nakamura S, Kato K, Yoshida A, Fukuma N, Okumura Y, Ito H, Mizuno K. Prognostic value of depression, anxiety, and anger in hospitalized cardiovascular disease patients for predicting adverse cardiac outcomes. Am J Cardiol. 2013 May 15;111(10):1432-6. doi: 10.1016/j.amjcard.2013.01.293. Epub 2013 Feb 20.
- National Institutes of Health. Emotional Well—Being: Emerging Insights and Questions for Further Insights: Round Table Meeting Report. April 3-4, 2018. Accessed at https://files.nccih.nih.gov/s3fs-public/Emotional%20Well-Being%20Roundtable%20Summary%20MASTER%20FINAL%20September2018_508.pdf?eq0JqgpH_u5wb.rYnOoikp6Il2Th05Wh
- Suinn RM. The terrible twos--anger and anxiety. Hazardous to your health. Am Psychol. 2001 Jan;56(1):27-36.
- Suls J. Anger and the heart: perspectives on cardiac risk, mechanisms and interventions. Prog Cardiovasc Dis. 2013 May-Jun;55(6):538-47. doi: 10.1016/j.pcad.2013.03.002. Epub 2013 Apr 6. Review.
- Wrosch C et al. Age-related changes in older adults’ anger and sadness: The role of perceived control. Psychology and Aging. March 2018. 33(2), 350-360.