Is This Worth Dying For?

by Dr. Stephen Sinatra
Filed Under: Heart Health, Heart Attack
Last Reviewed 02/06/2014

Earlier this week, research came out saying that anger and other strong emotions can trigger potentially deadly heart rhythms and cardiac arrest. It was another piece of health "news" that's hardly new--I've been seeing this very thing in patients for 30 years--but I'm still glad that this important connection is getting a little bump in media coverage.

The relationship between the mind and body is grossly overlooked in conventional medicine, and we would all benefit from being more mindful about its impact on our well-being. Just as emotions can help us heal, they can also harm us. And when it comes to our hearts, they are exceptionally powerful.

Early in my career, I noticed a common behavior pattern in many acute heart attack patients. They had the typical hard-driving, overachieving Type A personality that was quick to anger. This observation ultimately motivated me to study psychotherapy, and it didn't take long for me to realize that anger is the Achilles' heel of the cardiovascular system. When you become angry, your blood vessels constrict and your blood pressure rises as your body is flooded with stress hormones. The electrical currents to your heart become unstable. And if you have arterial plaque, anger is like throwing a match into a can of gasoline. The plaque can rupture, and the resulting clots can kill you.

With all of my patients, I talk about the standard heart risk factors and the importance of maintaining healthy blood pressure, homocysteine, C-reactive protein, Lp(a), and insuling sensitivity, and, when appropriate, we discuss reducing cholesterol. But I also talk to them about their emotions, particularly how they were feeling just before an angina episode or heart attack. Many have told me that they had an outbreak of anger before the event. One patient, an attorney, had his new car scratched with a key from one end to the other by a teenager. When he first saw the damage, the man got so angry that he had a heart attack on the spot.

Obviously, there's no way to avoid anger or stress--they are as much a part of life as breathing. But I do want to encourage you to think about how you react to frustration, pressure, and other types of adversity. Then, the next time you feel yourself losing control, ask yourself this very simple question: Is this worth dying for?

This is a question I learned from Dr. Robert Eliot, a fellow cardiologist who wrote a book by the same title. Dr. Eliot suffered a heart attack at age 44 and realized that the cause was stress. He also realized he would die if he didn't change his attitude toward life. He did--and so should we.

It's important to remember that even though we all get angry, we have a choice about how to express those feelings. We can go into a potentially fatal fit of rage, or we can defuse the anger and go back to the situation later on and deal with it after the emotional charge has passed.

If you have a difficult time controlling your anger, please seek the advice of a trusted friend, clergyman, or therapist. This may be a sign of long-term repressed anger, which can also lead to cardiovascular problems such as high blood pressure, atherosclerosis, and increased risk of heart attakc and stroke. 

For more information on heart risk factors and how to prevent them, visit

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