Amanda MacMillan: Health.com
In a new study, strenuous activity and bad mood were both common triggers—and the risk was highest if people experienced both at the same time.
A hard workout may seem like a good way to blow off steam after a fight with your partner or a disappointing day at work. But it might be smart to avoid going all-out in the heat of the moment: A new study suggests that combining heavy physical exertion with a negative emotional state could put you at increased risk for a heart attack.
Research
The research found that either factor was linked to heart attacks on its own, but that the association was strongest in people who experienced them both shortly before their symptoms started. That was true across all groups in the study—including people who had preexisting risk factors and those who didn’t.
Lead author Andrew Smyth, MD, PhD, highlights that this study is the first to encompass a wide range of regions and ethnic groups, setting it apart from previous studies on heart attack triggers.
The Circulation study analyzed data from 12,000 heart attack survivors in 52 countries, examining heavy physical exertion and emotional upset within an hour before symptoms started, as well as during the same hour the day before the heart attacks.
When the researchers compared people’s day-of and day-before responses, they found that heavy physical exertion was associated with a more than two-fold risk of suffering a heart attack. The same was true for being angry or emotionally upset.
“We did not find any significant differences between those with and without these risk factors,” Smyth told RealSimple.com. “Therefore, our findings apply to a wide population.” The authors found no significant difference between age groups—under 45, 45 to 65, or over 65—or gender, either.
The researchers conducted a sensitivity analysis, comparing the main study participants with a control group without prior heart attacks. (The control group was asked whether they’d experienced heavy exertion and/or anger or upset moods in the last 24 hours.) “Interestingly, by taking this approach we found very similar results,” says Smyth, “demonstrating that our results are robust.”
“Both increase blood pressure and heart rate, impacting blood flow and potentially leading to a heart attack,” explains the expert.
Over view
Overall, of course, exercise is good for the heart—and high-intensity exercise has benefits that can’t be matched with light physical activity alone. Smyth says his study is not meant to discourage hard workouts, but he does provide a few words of caution.
“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,” he says. That advice applies to everyone, he adds, including healthy people with no history of heart problems.
In fact, the study authors recommend avoiding extremes of either triggering event—physical exertion or being angry or upset. “Eliminating these triggers is impractical as they are part of daily life and unpredictable, according to Smyth in an email. “But we would encourage people to minimize exposure.”
According to Barry J. Jacobs, PsyD, the new study demonstrates the crucial mind-body connection.
“Excess anger can trigger deadly heart attacks,” warns American Heart Association. “All of us should practice mental wellness and avoid losing our temper to extremes.”
Jacobs
Jacobs agrees that people, especially those at higher risk of heart attacks, should avoid highly emotional situations. Peer support, such as talking with others facing similar challenges, can help manage emotions related to health conditions.
The study authors acknowledge that their study was only able to show an association, not a cause-and-effect relationship. They also say that, because the potential triggers were self-defined, opinions of what constituted heavy exertion, anger, or being upset surely varied from person to person.
Smyth says it’s subjective, as what’s strenuous for one person may be leisurely for another.
Avoid extremes and unusual situations, and try to avoid combining them when possible, says Jacobs.
This article originally appeared on RealSimple.com.
