I’ve made no secret of the fact that I’m angry about what appears to be a pattern of overuse and abuse in the Cellular Tissue Product (CTP) / skin substitute industry. In fact, just writing that sentence, I realize my mood is changing. Who wouldn’t be angry about fraud, the abuse of tax payer dollars, greed as a motivation for medical decision making, or the financial fleecing of elderly patients with huge co-pays that were not necessary when less expensive products were available? I can feel my blood pressure rising! I have been provoked into anger — for good reasons. It’s not my fault! I can’t help how I feel! Right?…

OK, I admit it. I have an anger management problem that I’m not proud of. I know it’s bad for my mental health. What I didn’t know is that anger could shorten my life.

A study recently published in the Journal of the American Heart Association explains the mechanism by which “provoked anger” is associated with an increased risk of cardiovascular disease events. The study examined the acute effects of provoked anger, and secondarily, anxiety and sadness on endothelial cell health. Healthy adults (n=280) were randomized to an 8‐minute anger recall task, a depressed mood recall task, an anxiety recall task, or an emotionally neutral condition. Pre−/post‐assessments of endothelial health including 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) were measured. They found that a brief provocation of anger adversely affected endothelial cell health by impairing endothelium‐dependent vasodilation. Unlike anger, the endothelial changes were not significant for anxiety and depression.

Anger made it harder for blood vessels to dilate in response to ischemia, affected cellular markers of injury, and affected the cells’ ability to repair themselves. The impact lasted for 40 minutes after the provocation episode, which isn’t really very long. But there might be a cumulative effect. In an interview with CNN Health, lead author, Daichi Shimbo expressed concern about the cumulative effects of anger. “We speculate that if you’re a person that gets angry over and over again, that you’re chronically impairing your blood vessels.”

While we can’t avoid feeling angry, we can learn to “process” it so that it doesn’t fester. That was the advice of Dr. Brett Ford, associate professor of psychology at the University of Toronto Scarborough, in a previous CNN Health article.

So, if you are angry about the Cellular Tissue Product (CTP) / skin substitute issue (regardless of which side of the fence you are on), feel free to comment on these posts, or better yet, send me a well-written letter. But please, try not to sound too angry. (And now you know why I have a blog… it’s for my endothelial well-being.)