updated 3/2/2004 2:00:45 PM ET 2004-03-02T19:00:45

Hotheaded men who explode with anger seem to be at greater risk of having a stroke or dying, new research shows. Their risk is even greater than men who are simply stressed-out Type A personalities.

Angry women, on the other hand, don’t run as high a risk of having a stroke or heart problems, according to a study released Monday in the American Heart Association journal Circulation.

The study showed that men who express their anger have a 10 percent greater risk than non-hostile men of developing an atrial fibrillation, a heart flutter that 2 million Americans have. It is non-threatening for many, but it can also increase the risk of stroke.

Men who unleashed their anger were also 20 percent more likely to have died from any cause during the study.

“There has been a perception that you can dissipate the negative health effects of anger by letting anger out instead of bottling it up,” said Dr. Elaine Eaker, lead researcher and president of Eaker Epidemiology Enterprises in Chili, Wis. “But that was not the case in this study.”

Hostility and heart disease
It also found that men who are generally hostile and contemptuous of other people are 30 percent more likely to develop the irregular heart rhythm than men with less hostility.

Atrial fibrillation can lead to stroke because the heart’s two upper chambers don’t beat effectively enough to pump out all the blood, allowing it to pool, form clots and increase stroke risk.

Researchers have long known about the link between anger and hostility and heart disease, but this study offers a more definitive association, said Dr. John Osborne, a cardiologist at Baylor University Medical Center in Grapevine, Texas, who was not involved in the study.

“There’s a lot of things we understand about atrial fibrillation ... but the question is what triggers it,” Osborne said. “I think this may give us a better appreciation.”

The research also is significant because, unlike other studies, it was long-term and based on a large group of people, he said.

The study analyzed more than 3,000 adult children of the original participants of a landmark study begun in 1948 in Framingham, Mass.

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Eaker said that the findings mean scientists can say with more confidence that anger and hostility serve as an independent risk factor. The researchers also determined there is no increased risk in men who rate high in Type A behavior — men who are often rushed, impatient and competitive.

More studies are needed to confirm the study, she said, because the Framingham study was not ethnically diverse and it’s always helpful to have replication.

“While we’re confident its accurate, it’s not appropriate to say it’s definitive,” she said.

The study followed 1,769 men and 1,913 women who had no signs of heart disease for 10 years.

Even when other risk factors were accounted for, such as other heart problems, high blood pressure, cholesterol and age, certain men still developed an irregular heartbeat.

“It was related to their attitude and temperament,” said Eaker, who conducted the study with colleagues at Boston University and the Framingham study.

No link in women
Researchers did not find a significant link between anger and hostility and the risk of developing atrial fibrillation in the women in the study.

Men have more heart disease at a younger age than women, so researchers may need to follow the women longer, Eaker said.

Osborne said when he first heard about the study, he thought about the old phrase, “Don’t get mad, get even.”

“I interpret it as one more indication that women are smarter than men,” he said. “They don’t go into rages."

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