Emotional upset and heavy exertion may trigger a heart attack


You know those movie scenes where a guy is arguing with another person while throwing straw bales in the pickup truck, and then he keels over with a heart attack? It can happen, say McMaster University investigators.

Research from a large international study says that being angry, emotionally upset or engaging in heavy physical exertion may trigger a heart attack.

In fact, there is an association, more than twice the risk, between anger or emotional upset and the onset of heart attack symptoms within an hour. The same is true for heavy physical exertion during the hour before a first heart attack. The association is stronger — more than triple the risk — in those patients who recalled being angry or emotionally upset while also engaging in heavy physical exertion.

“Previous studies have explored these heart attack triggers; however, they had fewer participants or were completed in one country, and data are limited from many parts of the world,” said Dr. Andrew Smyth, lead author and a researcher of McMaster’s Population Health Research Institute. He’s also a researcher at the HRB Clinical Research Facility in Galway, Ireland.

“This is the first study to represent so many regions of the world, including the majority of the world’s major ethnic groups.”

The study, published this week in the American Heart Associations’ journal Circulation.

Dr. Andrew Smyth, lead author and a researcher of McMaster’s Population Health Research Institute.

Researchers analyzed information from 12,461 patients with an average age 58, who participated in INTERHEART, a study consisting of patients with first-ever heart attacks across 52 countries. Participants completed a questionnaire about whether they experienced any of the triggers in the hour before their heart attack.

The researchers said that these triggers appeared to independently increase a person’s heart attack risk beyond that posed by other risk factors, including age, smoking, obesity, high blood pressure and other health problems.

Smyth said that extreme emotional and physical triggers are thought to have similar effects on the body.

“Both can raise blood pressure and heart rate, changing the flow of blood through blood vessels and reducing blood supply to the heart,” he said. “This is particularly important in blood vessels already narrowed by plaque, which could block the flow of blood leading to a heart attack.

“Regular physical activity has many health benefits, including the prevention of heart disease, so we want that to continue,” he said. “However, we would recommend that a person who is angry or upset who wants to exercise to blow off steam not go beyond their normal routine to extremes of activity.”

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