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expert reaction to study looking at negative emotions (including anger and anxiety) and measures of blood vessel function

A study published in the Journal of the American Heart Association looks at the effect of negative emotions on blood vessel function. 


Prof Riyaz Patel, Professor of Cardiology, UCL; and Consultant Cardiologist, St Bartholomew’s Hospital, London, said:

“Blood vessels are active structures and not just simple tubes.  They have an inner lining called the endothelium, which very meticulously controls things like how relaxed or constricted the vessel is, and performs other functions that when impaired could lead to stiffening or furring of those vessels, which in turn can cause heart attacks and strokes.

“The researchers here asked the question about what a short term emotional state, like being angry, does to the endothelium.  They show in an elegant experiment, using young people in a very controlled environment (making sure things like temperature, noise etc. were all controlled), that recalling memories that evoke anger, causes a temporary disruption in the usually healthy functioning of the blood vessels.  This response wasn’t so clear in other states of anxiety and sadness.  They compared these states to a neutral state of just counting numbers.

“The findings fit nicely with clinical experience as well as experimental understanding that strong emotions do affect blood pressure, constriction of arteries and heart health.  We know heart attacks happen more commonly in severe emotional states, or heart pump failure occurs after sudden distressing events – including the oft quoted “broken heart” syndrome.  The mechanisms by which emotion affects the heart have remained elusive as it is difficult to study at the time of the event.  The authors here have done well to try and simulate strong emotions in a laboratory setting.

“The study is quite large for its type, and is well conducted but we should keep in mind a few things.  Firstly this was in a very artificial setting and does not necessarily equate to what happens in the real world, where emotions may last longer or be more intense – arguably the effect could be larger.  The volunteers were also all young people, whereas people who have heart attacks or strokes are usually older, so future experiments should look at these groups to better understand if the same effect is there or if it is diminished in older and perhaps stiffer arteries that are already impaired.  The technology used to measure the health of the arteries (using finger tip probes) is not perfect and the measurements do vary a lot, as seen by the wide standard deviation of the measures.  This may explain the lack of positive results for the other emotional states.  It would also have been nice to see a “happy” or opposite state to see if this also evoked a similar response or a protective response, which the researchers may consider in future studies.  Finally, the study only shows a short term change in arterial function, but it remains unclear if this has longer term effects, and what happens when someone is repetitively exposed to such emotions – do they get blunted or amplified each time?  It is likely different people will respond to these short term changes in different ways.”



‘Translational Research of the Acute Effects of Negative Emotions on Vascular Endothelial Health: Findings From a Randomized Controlled Study’ by Daichi Shimbo et al. was published in the Journal of the American Heart Association at 10.00am UK time on Wednesday 1 May 2024.


DOI: 10.1161/JAHA.123.032698



Declared interests

Prof Riyaz Patel: “No relevant disclosures.”

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