CARDIOVASCULAR CONSEQUENCES OF ANGER AND OTHER STRESS STATES

Anger is the affective state most commonly associated with myocardial ischaemia and infarction and life-threatening arrhythmias, with at lea st 36 000 (2.4% of 1.5 million) heart attacks precipitated annually by anger in the United States, Fear, anxiety and bereavement are also im plicated in increased vulnerability to cardiac events. The lethal card iovascular consequences of these behavioural stress states in patients with ischaemic heart disease are attributable to activation of high-g ain central neurocircuitry and the sympathetic nervous system, provoki ng acute sinus tachycardia, hypertension, impaired myocardial perfusio n and cardiac electrical instability. The fields of epidemiology, beha vioural medicine and cardiovascular physiology have generated new meth odologies for studying the pathophysiology of anger and other behaviou ral stress states with the goal of developing means to sever the link between the anger and its life-threatening consequences.