EHJACC：冷静！冷静！生气可诱发心脏病发作！

  近日，来自悉尼大学的研究人员通过研究发现，当一个人在强烈愤怒后的两个小时内其心脏病发作的风险是正常情况下的8.5倍，相关研究刊登于国际杂志European Heart Journal： Acute Cardiovascular Care上，该研究中研究者首次揭示了急性情绪爆发和高风险的严重心脏病事件之间的关联。
  研究者Thomas Buckley说道，我们的研究证实了强烈愤怒的发作往往会诱发个体心脏病的发作，而研究数据也表明心脏病的高风险发作并不仅仅当你处于生气的时候，而这种高风险会在你生气发作后持续两个小时。这项研究中研究者将生气定义为级别5，同时研究者又设定了1-7范围的级别，分别表示：非常生气、身体紧绷、紧握拳头或咬牙切齿、准备爆发、达到愤怒阶段、情绪失控及乱扔东西。这些诱发强烈愤怒生气发作的诱因往往29%的和家庭成员的争论有关，42%的和其他人争论相关，14%的和工作有关，14%的和驾驶有关，相关的研究数据也表明焦虑的发作或许也会使得个体更易引发心脏病发作，高水平的焦虑和个体心脏病发作风险增加9.5倍直接相关。
  而强烈愤怒和焦虑风险的增加很有可能是由于个体心率、血压、血管收缩增加引发，而这些因素往往会增加个体诱发心脏病发作的风险。尽管当前因为生气诱发的心脏病发作的发生率仅为2%，但这些个体在情绪爆发后的两小时内患心脏病发作的风险则为正常情况下的8.5倍，因此当任何诱发心脏病发作的偶然事件的绝对风险足够低时，危险仍然存在，而本文的研究结果也提醒研究人员需要开发相应的策略来保护处于急性愤怒期的个体。
  Geoffrey Tofler教授说道，潜在的预防性措施或许是减压训练，来帮助减少个体愤怒发作的频率和强度，或者避免一些促进个体愤怒的活动，从而降低个体心脏病发生的风险。另外通过减少其它风险因素，比如高血压、高胆固醇等措施也可以有效改善个体的心理健康进而改善心脏病的发作情况。
  对于那些处于高风险的个体而言，当前可能的药物疗法比如β阻断剂和阿司匹林，在个体生气的时候服用可以干扰应激源和心脏病发作之间的关联；与此同时研究者表示，当有效控制个体的心脏病发作或抑制心脏病发作时，个体愤怒和焦虑的频率也应当被有效评估来帮助改善个体的机体健康。而本文给人们传递的信息就是需要知晓急性生气发作和焦虑发作的危害，对于个体进行自我控制来降低疾病发病风险也非常有帮助。（转化医学网360zhyx.com）
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转化医学网推荐的原文摘要：

Triggering of acute coronary occlusion by episodes of anger
European Heart Journal: Acute Cardiovascular Care    doi: 10.1177/2048872615568969
Thomas Buckley1,2 Soon Y Soo Hoo1 Judith Fethney2 Elizabeth Shaw1,3 Peter S Hanson1,3 Geoffrey H Tofler1,3
Aims: The aim of this study was to report the association between episodes of anger and acute myocardial infarction (MI) in patients with angiographically confirmed coronary occlusion.
Methods and results: 313 participants with acute coronary occlusion (Thrombolysis In Myocardial Infarction 0 or 1 at emergency angiography) reported frequency of anger episodes in the 48 h prior to MI. In primary analysis, anger exposures within 2 h and 2–4 h prior to symptom onset were compared with subjects’ own usual yearly exposure to anger using case-crossover methodology. Anger level ≥5 (on an anger scale of 1–7) was reported by seven (2.2%) participants within 2 h of MI. Compared with usual frequency, the relative risk of onset of MI symptoms occurring within 2 h of anger level ≥5 (defined as very angry) was 8.5 (95% confidence interval 4.1–17.6). Anger level <5 was not associated with onset of MI symptoms. Compared with 24–26 h pre MI, anxiety scores >75th percentile on State–Trait Personality Inventory were associated with a relative risk of 2.0 (95% confidence interval 1.1–3.8) and in those above the 90th percentile, the relative risk of MI symptom onset was 9.5 (95% confidence interval 2.2–40.8).
Conclusion: Findings confirm that episodes of intense anger, defined as being ‘very angry, body tense, clenching fists or teeth’ (within 2 h) are associated with increased relative risk for acute coronary occlusion. Additionally, increased anxiety was associated with coronary occlusion. Further study, including the role of potential modifiers, may provide insight into prevention of MI during acute emotional episodes.