Hostility May Affect Impact Of Emotional Stress

March 26, 1998

NEW ORLEANS -- Venting your feelings may not be good for your health after all -- but only if you're already an anger-prone individual -- according to a new study at Duke University Medical Center.

Hostile women who described a real life event that made them angry had significant increases in blood pressure and heart rate. But women who scored low on a standard hostility scale showed no greater increases in heart rate or blood pressure during the emotional testimonial than if they were reading a factual account of Abraham Lincoln's life, the study found.

Duke behavioral psychologist Edward Suarez prepared the results of his study for presentation Thursday at the Society of Behavioral Medicine conference in New Orleans.

"If anger-prone women exhibited this strong of a physical reaction to just talking about an emotional event, then repeated, lifetime exposure to stressful events could pose a real risk of damaging their arteries," Suarez said.

Emotional stress has been widely linked to cardiovascular disease, according to extensive research both at Duke and around the country. But Suarez's study points out that emotional stress may not be potentially harmful for everyone, only those who are already prone to feelings of anger and irritation. While conventional wisdom has long held that talking about your feelings makes you feel better, Suarez said that may not be true in all cases, especially if the stressful situation is unresolved and lingering.

"That doesn't mean counseling and psychotherapy are unhealthy -- in fact, just the opposite," Suarez said. "You have to be talking in a therapeutic setting, not just venting your anger over and over without any progress toward resolving the situation."

In a study of 52 middle-aged women who were mentally and physically healthy, Suarez found that hostile women experienced nearly an 11-point rise in systolic blood pressure when recalling an emotional event, compared to when they read a factual report devoid of emotional content. Low- hostile women, on the other hand, showed only a three-point rise in systolic blood pressure during anger recall, compared to the factual reading.

Systolic blood pressure (the top number of the equation) is significant because it is routinely used to evaluate cardiac risk, Suarez said.

Hostile women also showed an increase in heart rate of five beats per minute when recalling an angry event versus reading the factual report, whereas low-hostile women had no change in heart rate between the two tasks.

The research was supported by the National Heart, Lung and Blood Institute.

While both groups of women reported feelings of anger and irritation after the emotional testimony, the low-hostile women did not have a corresponding physical response to that anger, the study showed. In other words, the stress was in their mind but not in their body, Suarez said.

"Talking or reading aloud is slightly stressful for everyone, so naturally there will be a slight increase in blood pressure from your normal resting levels," Suarez said. "But adding emotional content to the task of talking aloud made a physical difference only if you were easily roused to anger to begin with."

Suarez has shown a similar pattern in young men and women, aged 18 to 26. In those studies, hostile individuals who were mildly harassed during a laboratory task produced excessive amounts of stress hormones, specifically cortisol and norepinephrine. They also showed an increase in blood pressure and heart rate. But low-hostile subjects showed no such increases.

Suarez said his next step will be to examine how emotional stress affects adrenalin, noradrenaline and cortisol in women -- three stress hormones that, when chronically elevated, can contribute to heart disease.

Duke University Medical Center

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