Friday, January 8, 2010

Anger: Heart Disease

How Anger Hurts Your Heart?

Yellers, ragers, and door slammers beware -- frequent high levels of anger have now been linked to heart disease.

If you knew that frequent anger might raise your risk of heart disease significantly, would you continue to blow off steam by yelling and smashing things during an argument or getting furious if the office email crashes during a rushed, stressful day?

It's time for hot heads to take heed: Increasingly, the negative, irritable, raging, and intimidating personality type worries heart researchers and doctors alike. "You're talking about people who seem to experience high levels of anger very frequently," says Laura Kubzansky, PhD, MPH, an associate professor at the Harvard School of Public Health in Cambridge, Mass., who has studied the role of stress and emotions on cardiovascular disease.

The key here is "high" levels. Moderate anger may not be the problem, according to Kubzansky. In fact, expressing anger in reasonable ways can be healthy. "Being able to tell people that you're angry can be extremely functional," she says. But explosive people who hurl objects or scream at others may be at greater risk for heart disease, as well as those who harbor suppressed rage, she says. "Either end of the continuum is problematic."

Anger's Physiological Effects on the Heart
So how exactly does anger contribute to heart disease? Scientists don't know for sure, but anger might produce direct physiological effects on the heart and arteries. Emotions such as anger and hostility quickly activate the "fight or flight response," in which stress hormones, including adrenaline and cortisol, speed up your heart rate and breathing and give you a burst of energy. Blood pressure also rises as your blood vessels constrict.

While this stress response mobilizes you for emergencies, it might cause harm if activated repeatedly. "You get high cortisol and high adrenaline levels and that is the cardiotoxic effect of anger expression," says Jerry Kiffer, MA, a heart-brain researcher at the Cleveland Clinic's Psychological Testing Center. "It causes wear and tear on the heart and cardiovascular system." Frequent anger may speed up the process of atherosclerosis, in which fatty plaques build up in arteries, Kiffer says. The heart pumps harder, blood vessels constrict, blood pressure surges, and there are higher levels of glucose in the blood and more fat globules in the blood vessels. All this, scientists believe, can cause damage to artery walls.

And anger might not be the only culprit. In Kubzansky's own research, she found that high levels of anxiety and depression may contribute to heart disease risk, too. "They tend to co-occur," she says. "People who are angry a lot tend to have other chronic negative emotions as well."

Emotions and the Heart
According to an analysis of findings from 44 studies published last year in the Journal of the American College of Cardiology, evidence supports the link between emotions and heart disease. To be specific, anger and hostility are significantly associated with more heart problems in initially healthy people, as well as a worse outcome for patients already diagnosed with heart disease.

The same study also showed that chronically angry or hostile adults with no history of heart trouble might be 19% more likely than their more placid peers to develop heart disease. The researchers found that anger and hostility seemed to do more harm to men's hearts than women's. Among patients already diagnosed with heart disease, those with angry or hostile temperaments were 24% more likely than other heart patients to have a poor prognosis.

In light of such findings, some doctors now consider anger a heart disease risk factor that can be modified, just as people can lower their cholesterol or blood pressure. "We're really good at treating heart attacks, but we're not that good at preventing them," says Holly S. Andersen, MD, cardiologist and director of education and outreach at the Ronald O. Perelman Heart Institute at New York-Presbyterian Hospital/Weill Cornell Medical Center. "Stress is not as easy to measure as your cholesterol level or your blood pressure, which are clearly objective. But it's really important that physicians start taking care of the whole person -- including their moods and their lives -- because it matters." The bottom line: "A change of mind can lead to a change of heart," Kiffer says.

Coping With Anger
Got a hair-trigger temper? Counseling and anger management might help in the long term, but what can you do for a quick fix?

Recognizing signs that you're getting angry and shifting your frame of mind will help, says Wayne Sotile, PhD, author of Thriving With Heart Disease. The next time you feel your anger -- and heart rate -- rising, try these coping statements to get a grip fast:

"I can't accomplish anything by blaming other people, even if they are responsible for the problem. I'll try another angle"

"Will this matter five years from now? (Five hours? Five minutes?)"

"If I'm still angry about this tomorrow, I'll deal with it then. But for now, I'm just going to cool off."

"Acting angry is not the same as showing that I care."

By Katherine KamWebMD the Magazine - Feature
Reviewed by
Louise Chang, MD

Our motto: One step ahead, everyday.

Monday, January 4, 2010


The alarm goes off, and it feels as if someone is hitting you with a hammer. It is the next morning after a night of drinking, and your head is pounding and your body is aching. Your mouth is dry, and you are thirsty. You try to move to a more comfortable position, and it only hurts more. To make matters worse, when you move, you discover that you are dizzy and nauseated. The room seems as if it is spinning. You put one foot on the floor to make it stop. It doesn't work. You have a hangover.

What Is a Hangover?
The term hangover refers to a constellation of unpleasant and painful symptoms that can develop after drinking too much alcohol. Those symptoms can range from mild discomfort to the more severe symptoms described above.

There is no set amount of alcohol that will cause a hangover, since each individual reacts to alcohol differently, but generally, the more you had to drink, the more severe the hangover symptoms.

The Symptoms of a Hangover
Most of the unpleasant symptoms experienced during a hangover are caused by two factors: the diuretic alcohol effect that causes the drinker to become dehydrated, and the toxic effects of alcohol poisoning of many systems of the body.

Excessive amounts of alcohol can affect the liver, the brain, the gastrointestinal system, the central nervous system and sensory perception. It can disrupt your sleep and other body rhythms, affect your mood and affect your attention and concentration.

The Causes of a Hangover
Most of the symptoms experienced during a hangover are caused by the direct effect of alcohol on the body's systems, as mentioned above, but there are many other factors that can add to the unpleasantness of a hangover that are not direct effects of the alcohol consumed.

Hangover symptoms can also be caused by the withdrawal of alcohol from the body, the effects of metabolites produced when alcohol is consumed, other chemicals found in alcoholic beverages, behaviors associated with drinking and personal characteristics of the drinker.

The Cure for Hangovers
There are many traditional practices that are thought to alleviate hangover symptoms, but some of them are unfounded myths that really don't help much at all. There are some practices that can actually make matters worse.

Left alone, hangover symptoms will go away on their own within eight to 24 hours, but when your head is pounding and the room is spinning, any treatment that can bring relief can sound like a good idea.

Preventing a Hangover
The best cure for a hangover is to never get one in the first place. People who drink nonalcoholic beverages do not get hangovers, and generally speaking, those who drink moderate amounts -- one drink a day for women and no more than two a day for men -- do not experience hangover symptoms.

If you drink any alcohol at all, though, you can experience negative consequences the next morning. Although there is no sure way to eliminate all of the unpleasantness of a hangover, there are steps that you can take to reduce the severity of the symptoms.

The Hangover as a Deterrent
For many people who experience a particularly severe hangover, it can be the motivation to never drink excessively again. It happens every day: someone has a very bad experience after drinking too much and they simply make a decision to quit drinking and they never drink again.
But it is not the case for all the people and that they don't easily decide to quit the drinking habit. For some people (usually psychologically dependents on alcohol), who are motivated to drink a particular day, may experience a prior psychological intoxication. This psychological intoxication may be more intense than the physiological intoxication and there are chances that it could be enough euphoric. It is this more intense psychological intoxication, that they never want to quit the drinking habit. This is because, as once a psychological need is gratified, people have a strong desire for the same need again. (As from the researches of Klub Psychology)

Others, though, continue to drink despite repeated bouts with severe hangover symptoms. Continuing to drink despite negative consequences can be sign of alcoholism or alcohol dependence or, at the very least, alcohol abuse. Heavy drinkers who have sworn to themselves "never again" during a hangover, but return to drinking a short time later, have, by definition, a drinking problem.

People who do not drink alcohol do not get hangovers. People who drink small amounts of alcohol rarely get hangovers. People who drink nonalcoholic beverages or those will very small amounts of alcohol within them rarely get hangovers.

However, people who drink to the point of intoxication usually experience some hangover symptoms. Among those who drink until they are intoxicated, those who drink large amounts of alcohol generally have more hangover symptoms compared with those who drink less.

Therefore, the best cure for a hangover is to prevent it from happening in the first place by not drinking alcohol at all, or by drinking very modest amounts. There are other steps that can help in hangover prevention, but once the symptoms of a hangover begin, there are few options that actually bring relief.

Some of the widely used, traditional hangover "cures" really do little to relieve symptoms and some of them can actually make the situation worse.

What Does Not Work?
There are several myths and urban legends surrounding curing a hangover that have been around for years. Most of them have no scientific basis:

· The Hair of the Dog That Bit You - The practice of having a drink the next morning to ward off the effects of a hangover doesn't really work in the long run, contrary to popular belief. Since the worse hangover symptoms occur when the drinker's blood alcohol content returns to zero, taking a drink the next morning only delays the inevitable. It may lessen the symptoms in the short term, but giving the liver more alcohol to metabolize will only increase the discomfort later. Additionally, a morning-after drink can lead to more drinking and can contribute to eventual alcohol dependence.

· Black Coffee - Coffee may relieve the feeling of fatigue associated with hangover and help alleviate the headache symptoms by restricting blood vessels, but that relief is only temporary and the symptoms will return. More importantly, coffee acts as a diuretic further dehydrating the body and increasing the hangover symptoms. Again, coffee may lessen some symptoms initially, but in the long run may cause more problems.

· Taking Tylenol Before Going to Bed - This treatment seems to make sense, but it fails on two levels. First, the effects of acetaminophen (Tylenol) will usually wear off before the onset of hangover symptoms. It would be better to take it after the symptoms begin. Additionally, when the liver is processing alcohol it cannot process acetaminophen as it usually does, which can cause liver inflammation and possible permanent liver damage.

· Eating Fried or Greasy Foods -
If you eat foods with a lot of fat before drinking, the oils can coat your stomach lining and slow down the absorption of alcohol. This can help prevent the severity of a hangover. However, eating greasy food the morning after a drinking bout will probably only add to the gastrointestinal malaise by irritating the stomach and intestines.

· Eating Burnt Toast -
Carbon can act like a filter in the body and activated charcoal is used to treat some types of poisonings, but the carbon found on burnt toast is not activated charcoal and it does not work the same in the body. Over-the-counter products sold as hangover cures that contain carbon are intended to be taking before drinking, not after the hangover begins.

What Does Work to Relieve Hangovers?
The only real cure for a hangover is time. If no more alcohol is consumed, hangover symptoms should subside between eight and 24 hours. There are some things that can be done to relieve some of the most severe symptoms.

· Water or Sports Drinks - The dehydration effects of alcohol causes some of the most discomfort associated with hangovers -- headache, dizziness, and lightheadedness. The quickest way to relieve those symptoms is to drink lots of water. Sports drinks, such as Gatorade, will not only relieve dehydration, but also replace needed electrolytes.

· Painkillers - Aspirin and ibuprofen (Advil or Motrin) may reduce hangover headache and muscle pain, but should not be used if you are experiencing abdominal pain or nausea. The medications themselves are gastric irritants and can compound gastrointestinal hangover symptoms. Acetaminophen (Tylenol) should not be taken during a hangover because alcohol metabolism enhances acetaminophen's toxicity. Also, ibuprofen taken when dehydrated can sometimes cause kidney dysfunction especially in persons with poor kidney function.

· Eggs - Because eggs contain cysteine, which breaks down acetaldehyde in the body, eating eggs the morning after a drinking binge could help remove the hangover-causing alcohol metobolite toxin from the body.

· Bananas - Alcohol, like any diuretic, depletes the body of potassium. Eating bananas, or other fruit high in potassium, while having hangover symptoms can replenish the potassium and lost electrolytes. Sports drinks typically are good sources of potassium.

· Bouillon Soup - If you can't handle the idea of eating anything solid while experiencing severe hangover symptoms, try some bouillon soup. It also can help replace salt and potassium lost during a drinking binge.

· Fruit or Fruit Juice - Consuming fruit or fruit juice while hungover can increase energy, replaces vitamins and nutrients and has been shown to speed up the body's process of getting rid of toxins. Fruits and fruit juices therefore can help decrease the intensity of hangover symptoms.

The Bottom Line
Drinking as much water as possible over the course of the evening and before you go to bed will relieve a great deal of the hangover symptoms caused by dehydration. But only time will cure the hangover symptoms caused by the alcohol poisoning effects of excessive drinking.

Our motto: One step ahead, everyday.