Effect of Anger Provocation on Endothelium-Dependent and -Independent Vasodilation
Anger is an independent predictor of coronary heart disease events, although the mechanisms for this relation are unclear. The effects of an anger-provoking interview compared with a neutral interview on endothelium-dependent and -independent vasodilation assessed by brachial artery ultrasound were examined in 14 healthy subjects without coronary heart disease risk factors. The anger provocation condition, but not the neutral condition, caused a significant impairment in endothelium-dependent vasodilation at 90 minutes compared with baseline (p = 0.004) and 30 minutes (p = 0.013). Similarly, endothelium-independent vasodilation was significantly impaired at 90 minutes after the angry interview compared with baseline (p = 0.003) and 30 minutes (p = 0.001). The decreases in endothelium-dependent and -independent vasodilation were greater after the anger-provoking interview than after the neutral interview, especially between 30 and 90 minutes. In conclusion, preliminary results suggest that an episode of anger is associated with a dysregulation in endothelium-dependent and -independent pathways, suggesting that these mechanisms might contribute to the link between anger and coronary heart disease events. Although anger is associated with increased short- and long-term risk for coronary heart disease (CHD) events, independent of traditional CHD risk factors,1, 2, 3, 4, 5 and 6 the mechanisms that underlie this relation are unknown. Endothelial dysfunction plays a major role in the development of atherosclerosis.7 Traditional CHD risk factors are associated with endothelial dysfunction8 and may also impair arterial vasodilation in response to exogenous nitric oxide (NO), suggesting concomitant vascular smooth muscle dysfunction.8 and 9 Thus, the higher risk for CHD events associated with anger may be similarly mediated through an impairment in endothelium-dependent vasodilation (EDV) with or without an impairment in endothelium-independent vasodilation (EIV). To our knowledge, the effects of anger on EDV and EIV have never previously been examined. To test this hypothesis, we examined the effects of anger induction in humans on EDV and EIV assessed by brachial artery ultrasonography.
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