Although heart disease causes half of all deaths in the United States, it is one of the most preventable chronic disorders. Reducing dietary fat, maintaining optimal weight, stopping smoking, and exercising are all things you can do to help to prevent the disease. But could mental factors also help keep you heart-healthy?

Some researchers think so. A recent study from the University of North Carolina showed that people who are prone to anger are about three times more likely to have a heart attack or sudden cardiac death than those who are the least prone to anger. The North Carolina study examined 13,000 subjects, all of whom were free of heart disease at the beginning of the project. Over the six years of the study, 256 subjects had heart attacks; the greatest proportion occurred among those who scored the highest on the 40-point anger scale. They answered “yes” to questions about being “hot-headed” and “quick-tempered,” and to feeling like hitting someone when they get angry. 

The researchers noted that there has long been a suspicion that emotional states such as anger, anxiety, and depression have an impact on health. This study actually documented this, and the findings held true even after taking into account other risk factors for heart disease, they added. 

Just as negative emotions can be linked to heart attack, positive thinking and a healthy outlook have been shown to help the heart heal, according to a Duke University study. These investigators concluded that optimism was a powerful predictor of who would live and who would die after being diagnosed with heart disease. 

The Duke study included 1,719 men and women who had undergone coronary catheterization and received a diagnosis of heart disease. During interviews at the time of this procedure, 14% of the subjects expressed doubts that they would recover enough to resume their daily routines. After one year, 12% of these pessimists had died, compared with only 5% of the patients who expressed optimism about recovering. Even when the severity of the patients’ disease was taken into account, their outlook was still a crucial factor in survival. In fact, pessimism was even more harmful than depression, which has also been shown to lower a person’s recovery from heart disease.

Researchers in both studies pointed out that stress management techniques might help anger-prone individuals develop better coping skills to deal with frustration. They noted that counseling, support groups, and a supportive social network may help bolster your attitude and outlook.