Emotionally
stressful events, and more specifically, anger, immediately precede and appear
to trigger the onset of acute myocardial infarction (MI) and other
cardiovascular events.
Outbursts of
anger increase the risk of acute myocardial infarction, acute coronary
syndrome, ischemic stroke, ruptured intracranial aneurysm and ventricular
arrhythmia. This was corroborated by a systematic
review and meta-analysis published in the European Heart
Journal, which found a higher risk of cardiovascular events in
the 2h after outbursts of anger (Eur Heart J. 2014
Jun 1;35(21):1404-10).
An earlier
study from Deaconess Hospital, Harvard Medical School published in the journal
Circulation in 1995 had shown that episodes of anger are capable of triggering
the onset of acute myocardial infarction and that that this risk may be reduced
by the use of aspirin (Circulation. 1995 Oct 1;92(7):1720-5). More
than 1600 patients were studied, of which 39 were found to have episodes of
anger in the 2 hours before the onset of MI. The relative risk of MI in the 2
hours after an episode of anger was 2.3. This risk was mitigated by aspirin.
Compared to nonusers, patients who were taking aspirin regularly had a
significantly lower relative risk; 1.4 vs 2.9, respectively.
These
studies caution that heart patients on aspirin should continue to take aspirin
to prevent anger-induced heart attack or stroke.
The description
of anger comes in mythology as one of the five vices which need to be
controlled to acquire spirituality. The description of anger in mythology is as
under:
- Lord Shiva is also shown
wearing a snake in his neck with hood directed inwards. Shiva is also said
to have a blue neck or Neelkanth indicating that to control anger one
should neutrilise then anger continuously (matted hairs) with cool mind
(Moon) using positive flow of thoughts (ganga) with ego controlled (naag)
- Bhagavad Gita talks about
anger in great details and tells that anger is as a result of unfulfilled
of desires. As per Bhagavad Gita lust leads to anger and anger leads to
ego.
- As per Lord Shiva, anger
can be expressive and or suppressive. Expressive anger can lead to rupture
of arterial blockage and suppressive anger can lead to arterial blockage.
The best answer described by Lord Shiva is to manage and control the
anger.
- Two forms of Goddess
Durga and Kali also indicate when to get angry.
- As per mythology, one
should learn to control anger but it also talks about allowable spiritual
anger when it is done for the benefit of the mankind.
The period
of Uttarayana has started, which is the phase of a positive state of mind. But
even then people with angry temperament, especially heart patients on aspirin
should not miss their daily aspirin dose.
It is
equally important to learn to manage one’s anger.
- As per Shiva Puran, anger
management is described under Neelkanth role of Lord Shiva. The blue color
means slow poison (one of them being anger) which is kept in the neck. It
indicates that anger should not be expressed or suppressed but should be
managed. Management involves continuously (Jatadhari) with cool mind
(Moon), one should direct positive thoughts (Ganga) towards the reason for
anger keeping the ego under control (Naag) with head directed in.
- As per Bhagwad Gita,
anger is always resulting of non-fulfillment of desires. Therefore, one
must act at the levels of desires.
- As per Marshal Rosenberg,
indulging in non-violent communication helps in managing anger.
- Drugs like SSRI used in
modern medicine, primarily focus on reducing irritability and chronic
anger. They may take as long as 10 weeks to act. Aspirin is also
recommended in people with un-managed anger to prevent occurrence of heart
attack.
Anger recall is as bad as anger itself, which can be expressive or
suppressive. Both are dangerous. Expressive anger causes plaque
to rupture leading to heart attack or MI, while suppressive anger causes
chronic sympathetic overactivity that helps plaque formation.
Dr KK
Aggarwal
Padma
Shri Awardee
President
Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group
Editor-in-Chief IJCP Publications
President
Heart Care Foundation of India
Past
National President IMA
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