Endothelial cell (EC) health is negatively impacted by provoked anger through the impairment of endothelium-dependent vasodilation (EDV), a new study shows. However, other core negative emotions, such as anxiety or sadness, do not have this impact on ECs. These findings were reported by Daichi Shimbo, MD, of Columbia University Irving Medical Center, New York, and colleagues, in a manuscript published Wednesday online in the Journal of the American Heart Association. “We saw that evoking an angered state led to blood vessel dysfunction, though we don’t yet understand what may cause these changes,” Shimbo said in a news release. “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.” Anger is known to increase the risk of cardiovascular events. The cascade of mechanisms from the core negative emotions — anger, sadness and anxiety — to cardiovascular disease is unknown. ECs play a key role in the maintenance and functioning of the cardiovascular system, and emotions may have an impact on ECs. The primary purpose of this study, the PUME (Putative Mechanisms Underlying Myocardial Infarction Onset and Emotions) trial, was to examine the effects of provoked anger on EC health. The trial enrolled subjects between August 2013 and May 2017. The primary outcome consisted of various measures of EC health. A total of 280 apparently healthy adults were randomized to an 8-minute anger recall task (n=72, mean age=26.3 years, 54% female), a depressed mood task (n=69, mean age=26.1 years, 58% female), an anxiety recall task (n=70, mean age=25.9 years, 44% female) or a task that was designed to elicit an emotionally neutral mood (n=69, mean age=26.8 years, 50% female). Measurements of EC health were taken pre− and post-assessment: endothelium-dependent vasodilation (reactive hyperemia index), circulating endothelial cell-derived microparticles (CD62E+, CD31+/CD42− and CD31+/Annexin V+) and circulating bone marrow-derived endothelial progenitor cells (CD34+/CD133+/kinase insert domain receptor+ endothelial progenitor cells and CD34+/kinase insert domain receptor+ endothelial progenitor cells). On the reactive hyperemia score, there was a group x time interaction between the anger and the neutral groups from baseline to 40 minutes (p=0.007). Mean changes in the reactive hyperemia index score were 0.20 in the anger group and 0.50 in the neutral group. In the anxiety versus neutral group, this score came close to, but did not reach. statistical significance (p=0.054), and in the sadness versus neutral group there was no statistical significance (p=0.160). No statistical significance was observed in the group x time interactions from baseline to 40 minutes between anger, anxiety and sadness versus the neutral group on the endothelial cell-derived microparticles and endothelial progenitor cells. Overall, this study demonstrated the adverse effects of provoked anger on EC, specifically EDV. The trial was funded by the National Heart, Lung and Blood Institute. Source: Shimbo D, Cohen MT, McGoldrick M, et al. Translational Research of the Acute Effects of Negative Emotions on Vascular Endothelial Health: Findings From a Randomized Controlled Study. J Am Heart Assoc. 2024 May 1 (Article in Press). Image Credit: American Heart Association