P60 Influence of Anger on Endothelial Dysfunction in Patients with Recent Myocardial Infarction

Abstract

Background

The literature demonstrates that anger is associated with cardiovascular disease, but the underlying physiological mechanisms remain undefined. Endothelial dysfunction, present in atherosclerosis, has also been associated with anger.

Purpose

To examine the association between anger and endothelial function measured by flow-mediated dilatation (FMD) of the brachial artery.

Methods

Patients were assessed during hospitalization after acute myocardial infarction answered the Spielberger Trait-State Anger inventory (STAXI). After discharge, patients were submitted to ultrasound of the brachial artery, the FMD technique, which was calculated by the maximum percentual of change in the diameter of the brachial artery from baseline to peak of dilation after deflation of the cuff.

Results

The study included 90 patients, 86% caucasian, with 57 ± 10 years old, 73% male, 48% smokers, 57% with hypertension, 32% with dyslipidemia, 23% with diabetes, and 21% with a family history of arterial disease coronary artery disease. The mean dilation of this group was 6.70 ± 4.64. The presence of endothelial dysfunction was evaluated by the percentage of arterial dilation below 8.0%. In the multivariate analysis, only the anger reaction was associated with endothelial dysfunction. At each point of anger reaction increases 31% the chance of endothelial dysfunction (p = 0.008).

Conclusions

In this sample of infarcted patients with anger score below average, the anger reaction is related to endothelial dysfunction.