Jim Morrison had one, so did Salvador Dali and Elvis Presley; no, the answer is not “a small poodle”, it is “a heart attack” and we know that heart attacks can be deadly. What may not be so widely appreciated is that heart attacks can have emotional causes but as a new study has shown, angry or anxious episodes increase your chances of a heart attack in the short term.

In the new study researchers gathered participants with acute coronary occlusion, which is a blockage in an artery that supplies blood to the heart. The study was conducted by researchers from the University of Sydney and the subjects had all been admitted to a primary angioplasty centre in Sydney having had a suspected heart attack. In the four days following their admission with a heart the 313 subjects were questioned about their activities in the 48 hours leading up to the heart attack. Specifically they were asked to rate their levels of anger in those two days on a scale from “1” (calm) to “7” (enraged and out of control, throwing objects and hurting self or others).

The results showed that people who had experienced anger at level 5 (very angry, body tense, clenching fists or teeth, ready to burst) or above in the two days prior to symptoms were 8.5 times more likely to have a heart attack in the two hours following the anger episode. Additionally, people who experienced acute anxiety episodes were 9.5 times more likely to experience a heart attack in the following two hours.

This is probably because anger and anxiety cause increases in heart rate, raised blood pressure, narrowing of the blood vessels and increased clotting. Of course the people in this study were a group presenting with heart attacks so they may not be representative of the general population but it still suggests that for people at risk then an acute anger or anxiety episode increases your heart risk for a couple of hours.

As a result we can quite rightly add anger and anxiety to high blood pressure, high cholesterol, and smoking as risk factors for heart attack. Your emotions are intimately bound up with your physical health and if you are happy, your heart is happy too.

Cardiovascular disease (CVD) is the term used for heart, stroke, and blood vessel diseases. It is the leading cause of death in Australia, accounting for 33 per cent of all deaths in Australia in 2009. Break that down and you find that cardiovascular disease kills one Australian every 11 minutes. Treating CVD costs the Australian economy more than $6 billion every year. This is all despite the many significant advances in the treatment of CVD and some of its risk factors that have occurred in recent years. Now, however, the news from Harvard researchers is that to really protect yourself against CVD you just need to be happy.

The researchers started out by noting that there is a well proven link between negative emotional states and CVD. Anger, anxiety, hostility, and depression are all known to increase your risk of developing either heart disease or CVD. What is less well known however, is the effect of positive states such as happiness on CVD. At least, it is less well known in hard research terms despite what common sense may tell you, but sometimes even the bleedin’ obvious needs to be backed up by data before we really believe it.

To look for that data the Harvard researchers reviewed the results of more than 200 published studies. They looked for links between cardiovascular health and a whole range of factors including happiness, psychological wellbeing, smoking, alcohol, exercise, sleep, and diet.

They found that independent of all the traditional risk factors, happiness and psychological wellbeing consistently protects against CVD. In particular, optimism was found to significantly reduce the risk of cardiovascular “events”.

Of course happiness and positive emotions set up hormonal states within the body that support wellbeing but it is also true that people with a positive outlook are more likely to exercise, eat a balanced diet, get enough sleep, and generally behave in ways that promote health.

As these researchers observed, if happiness and positive emotions precede cardiovascular health then the message for public health management and policy makers must be that simply discouraging risky behaviours and negative emotions is not enough, we should be looking as a matter of public policy to actively create conditions that promote public happiness.

It seems the perfect opportunity to bring together the musical talents of an apparently disparate group; Louis Armstrong, The Partridge Family, and Bruce Springsteen. If we could do as David Cassidy and his fellow Partridge’s encouraged and “c’mon get happy”, then perhaps The Boss could change his lyric slightly to “everybody’s got a happy heart” and then, as Satchmo observed, “what a wonderful world it would be”.