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09/11/91

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RESEARCH SHOWS HOW ANGER AFFECTS HEART PATIENTS

Anger appears to cause a reaction in the blood flow of heart patients that is at least as severe as that caused by exercise, according to a Stanford University researcher who is measuring the patients' reactions with high-technology equipment.

Although some researchers have long suspected that anger could affect blood flow in the same way exercise does, "this is the first time that it has been demonstrated," said Charles Benight, a doctoral candidate in counseling and health psychology at Stanford.

Results of Stanford studies of the ways hearts function under stressful conditions were reported by Dr. Gail Ironson at the American Psychological Association meeting in San Francisco last month. Benight discussed the research in issuing a call for volunteers to help with a second study he is conducting.

He said Ironson and colleagues found "a significantly greater proportion of heart patients with ischemia (a deficiency in the blood supply to the heart) after recalling an angry episode than healthy subjects. The effect for anger was stronger than other stressors like mental arithmetic and even physical exercise."

This study measured heart functioning through a technique called radionuclide ventriculography, which measures ischemia through ejection fraction and wall motion abnormalities.

Benight's further studies use even more sophisticated measuring devices. He is looking for healthy male volunteers between the ages of 40 and 80 to be used as a control group.

Benight is working with Dr. C. Barr Taylor, associate professor of psychiatry at Stanford School of Medicine, and Dr. George Segall, assistant chief of nuclear medicine at the Palo Alto Veterans Affairs Medical Center, on the new research project.

Men who volunteer for the study will be asked to spend about half a day at the PAVAMC, but it will be time well spent. "They'll get a high-tech assessment of their heart functioning at no cost," Benight said. "It's an expensive, high-tech procedure."

The key to the examination is a medical imaging device called a PET (for positron emission tomography) scanner that is able to show whether body organs are functioning normally. The PET scanner at the PAVAMC is the first in clinical use in Northern California.

People being tested in Benight's study lie on a table that slides through a ring, which emits the positrons. "When they are comfortable under the ring, they are injected with rubidium-82 (a radioactive isotope)," he explained. "The rubidium moves through their system very quickly as the machine images. Then it stores the images in the computer and we get them out of the computer later.

"We also have a video camera to measure facial expressions. Subjects also have continual ekg (electrocardiogram) monitoring and we take blood pressure at the same time."

When all the monitoring devices are in place, Benight runs baseline tests while the patients are relaxing. Then he has them recall experiences that made them angry.

"The real key to the study is to have participants actually try to relive past emotional experiences," he said.

Results from this study will attempt to replicate what the earlier research showed: increased perfusion for healthy people exposed to stress and reduced perfusion in diseased vessels for people with heart conditions.

Increased perfusion, Benight explained, "means that more blood per unit time will flow through the vessels of the heart."

That's the expected result of exercise or other stress in healthy individuals. But in people with diseased vessels, it is hypothesized that stress results in less perfusion or decreased blood flow in those vessels, which can lead to other heart problems.

In his research, Benight hopes to add a new dimension to the finding that anger can cause as much stress as exercise. He's asking subjects to recall not only anger, but situations where they felt anger and helplessness at the same time. He thinks the combination may prove to cause more stress than anger alone.

There are plenty of heart patients available for the study, but Benight needs more healthy subjects, "with no history at all of heart disease."

Besides being in the 40-80 age range, the volunteers should have cholesterol levels of 220 or lower and blood pressure readings in the normal range of 120 over 80.

The results of the high tech assessment will eventually be provided to the volunteers' doctors, Benight said.

Anyone wishing to volunteer, or to receive more information, may call Benight at (415) 858-3945 and leave a message.

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