A new study asks an interesting question: What happens inside the body when we are angry or stressed?

Anger, anxiety and sadness have all been linked with having a heart attack or other cardiovascular disease events.

For example, the chances of you having a heart attack spikes on Christmas Day – up to nearly 40 per cent – a few hours into the celebrations, because of heightened emotional stress.

According to the American Heart Association, intense sadness or similar emotions “are a common trigger for Takotsubo cardiomyopathy, which is a temporary heart condition that develops in response to an intense or emotional physical experience, where the heart struggles to pump blood effectively.

Events such as earthquakes “or even as a fan watching a World Cup soccer match, which provoke stress, may lead to myocardial infarction” or arrhythmias (irregular heart beats).

The new study investigates what happens in the blood vessels when a person is provoked with anger, anxiety or sadness.

Specifically, they looked at the endothelium, a single layer of cells which line all your blood vessels and lymphatic vessels.

Endothelial cells provide a space for your blood and tissues to interact.

When something goes wrong with your endothelial cells, there can be severe consequences in your body.

Of note, the endothelium is a key player in myocardial ischemia and atherosclerotic heart disease.

What happened in the study?

Researchers from Columbia University Irving Medical Centre in New York City enlisted 280 young and healthy adult participants.

These were randomly assigned to one of four emotional tasks for eight minutes:

• Recalling a personal memory that made them angry
• Recalling a personal memory of anxiety
• Reading a series of depressing sentences that evoked sadness
• Or repeatedly counting to 100 to induce an emotionally neutral state.

The endothelium of each participant was assessed for evidence of impaired blood vessel dilation.

Increased cell injury and reduced cell repair capacity were also assessed.

These measurements were taken at baseline (zero minutes) and at four different timepoints after completing the emotional task: Three minutes, 40 minutes, 70 minutes and 100 minutes.

The analysis found that recalling past events causing anger led to an impairment in blood vessel dilation. This happened because the endothelial cells failed to relax when anger was in play.

This impairment, which affected blood flow, occurred from zero to 40 minutes after the task.

The impairment was no longer present after the 40-minute mark.

This impairment of blood vessels’ ability to relax tends to increase the risk of developing atherosclerosis which, in turn, increases the risk of heart disease and stroke.

What about anxiety and sadness?

“There were no statistically significant changes to participants’ blood vessel linings at any time points after experiencing the anxiety and sadness emotional tasks,” the researchers reported.

“Impaired vascular function is linked to an increased risk of heart attack and stroke,” said lead study author Daichi Shimbo, a professor of medicine at Columbia.

“We saw that evoking an angered state led to blood vessel dysfunction, though we don’t yet understand what may cause these changes.”

Dr Shimbo said that investigation into the underlying links between anger and blood vessel dysfunction “may help identify effective intervention targets for people at increased risk of cardiovascular events”.

In the meantime, here is a helpful tip to help you with your anger.