Not expressing work anger doubles heart attack risk

Previous research has indicated that "covert coping" with unfair treatment at work - where an individual does not openly show to the perpetrator that s/he has been unfairly treated - is associated with risk factors for cardiovascular disease.

The Swedish researchers base their findings on workplaces in Stockholm participating in the Work, Lipids and Fibrinogen Stockholm (WOLF) study and 2,755 male employees who had not had a heart attack at initial screening between 1992 and 1995 when the study began.

The initial screen included an assessment of risk factors, such as high cholesterol/blood pressure and lifestyle, and coping responses to unfair treatment or conflict at work.

Participants were asked whether they used avoidance tactics, such as walking away from the situation or letting things pass without saying anything, and how often they did so. They were also asked if they experienced any physical symptoms, such as headache as a result, and whether they instead vented their anger at home.

Details of whether any of these men subsequently had a heart attack or died as a result of coronary artery (ischaemic) heart disease in the period up to 2003 were gathered from national registers of hospital treatment and deaths.

Up to 2003, 47 men had a heart attack or died from ischaemic heart disease.

Physical symptoms and the venting of anger at home were not associated with increased risks.

But after taking account of factors likely to influence the results, including job strain and biological factors, those men who persistently failed to openly express their anger were more than twice as likely to have a heart attack or die of serious heart disease as those who did show their anger.

And those who sometimes or often walked away from conflict, rather than letting things pass without saying anything, had three times the risk of having a heart attack or dying from ischaemic heart disease.

The evidence suggests that while coping mechanisms depend on individual preference, they are also dictated by the level of job control, say the authors.

Those with little job control are more likely to repress their anger.

But in this study, this was accounted for, suggesting that low job control did not explain the increased risk.

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Source: The Journal of Epidemiology and Community Health