Heavy physical exertion, anger and emotional upset are risk factors for a heart attack

This paper studied whether heavy physical exertion and emotional upset or anger could trigger a heart attack. Authors reported that these factors were associated with an increased risk of a heart attack.

Heavy physical exertion can be a temporary strain on the heart. Anger or emotional upset can also increase blood pressure, which can affect heart health over time. Previous studies have suggested that these may indeed be risk factors for a heart attack. However, larger studies are needed to confirm the link between physical exertion or emotional upset and heart attacks.

This study included 12,461 patients from 52 countries who had experienced a heart attack. Patients were asked whether they had heavy physical exertion or were angry or emotionally upset in the 1 hour before the heart attack. This was compared to a control period, the same hour 1 day before the heart attack.

13.6% of patients reported heavy physical exertion in the hour before the heart attack. 9.1% of patients reported heavy physical exertion during the control period. Patients who reported physical exertion were 2.31 times more likely to have a heart attack within 1 hour after physical exertion compared to the control period.

14.4% of patients reported anger or emotional upset in the hour before the heart attack. 9.9% of patients reported anger or emotional during the control period. Patients who reported anger or emotional upset were 2.44 times more likely to have a heart attack within 1 hour of experiencing anger or emotional upset compared to the control period.

The risk of a heart attack increased 3-fold for patients reporting both physical exertion and anger or emotional upset within 1 hour preceding it.

These results were not affected by medications, country, and timing of the heart attack. 

The authors concluded that heavy physical exertion and anger or emotional upset are risk factors associated with a first heart attack. This applied to both men and women, all age groups, and patients from many regions of the world. 

Heavy physical exertion and anger or emotional upset are common and do not always lead to a heart attack. Heavy physical exertion was reported as a risk factor for heart attack, but not any physical activity. Clinicians should continue to advise patients about the lifelong benefits of exercise.