Anger management may improve cardiovascular outcomes in post-MI patients, according to a clinical trial. The study aimed to assess the effect of anger management using cognitive behavioral techniques on endothelial function in patients with recent myocardial infarction (MI).
Endothelial function is essential in maintaining the health of the cardiovascular system. Endothelial dysfunction is a precursor to the development of atherosclerosis and other cardiovascular diseases. Flow-mediated dilation is a non-invasive method of assessing endothelial function by measuring the changes in the diameter of the brachial artery in response to reactive hyperemia. Reactive hyperemia is a temporary increase in blood flow to an organ or tissue due to a brief period of ischemia.
Anger is a normal emotion that people experience in response to a perceived threat or injustice. However, excessive or uncontrolled anger can lead to adverse physiological responses, including increased heart rate, blood pressure, and inflammation, which can damage the endothelial lining of blood vessels. This can increase the risk of cardiovascular diseases, including heart attacks and strokes.
Cognitive behavioral therapy is a form of psychotherapy that aims to change negative thoughts and behaviors that contribute to psychological problems. It is an effective treatment for anger management, as it teaches individuals to recognize and challenge their negative thoughts and beliefs, develop coping strategies, and improve communication and problem-solving skills.
The trial enrolled patients with ST-elevation MI and low anger control scores. They were randomized into two groups, with one receiving anger management intervention and the other serving as the control group. The primary endpoint was the difference in the variation of flow-mediated dilation (FMD) in the brachial artery from baseline to the 3-month follow-up. The secondary endpoint was major cardiovascular events at the 24-month follow-up.
The results of the study showed that both groups demonstrated a significant improvement in anger control from baseline to endpoint. However, the difference in intergroup variation was not statistically significant. The difference in FMD variation from baseline to the 3-month follow-up was significantly higher in the intervention group, with a medium effect size of 0.057 (p = .024). There was no difference between the two groups regarding major cardiovascular events.
The findings suggest that anger management through cognitive behavioral techniques may improve endothelial function in post-MI patients with low anger control. However, the study does not provide clear evidence on the mechanism by which the intervention improved endothelial function. More extensive studies with larger numbers of patients, assessments of changes in anger, improved comparability of pre-intervention FMD, and longer follow-up are necessary to confirm the results of this trial.
The results of this clinical trial suggest that anger management using cognitive behavioral techniques may improve endothelial function in post-MI patients with low anger control. However, further studies are necessary to confirm the findings and determine the mechanisms underlying the intervention's beneficial effects. Anger management may be a valuable adjunct therapy for patients with cardiovascular diseases, as it may improve their overall cardiovascular health and reduce the risk of adverse outcomes.