New research shows that anger may trigger a heart attack, adding yet another entry to the list of emotions that may actually kill you.

Dr. Elizabeth Mostofsky, a researcher at the Harvard School of Public Health and lead author of the new study, said that a person’s risk of heart attack, or acute myocardial infarction, surges following a rage episode. For the hot-tempered, this could mean a chronically elevated risk. "Although the risk of experiencing an acute cardiovascular event with any single outburst of anger is relatively low, the risk can accumulate for people with frequent episodes of anger," she said, speaking to BBC News.

The study, which is published in the European Heart Journal, reviewed data from nine previous studies involving thousands of participants. Taken together, these investigations suggest that an outburst is associated with a fivefold increase in heart attack risk that lasts for about two hours. During this time, you are also three times more likely to suffer a stroke.

Doireann Maddock, a senior cardiac nurse at the British Heart Foundation, told reporters that several biological factors may account for this surge. "It's not clear what causes this effect,” she said. “It may be linked to the physiological changes that anger causes to our bodies, but more research is needed to explore the biology behind this.”

When Emotions Kill

The current study dovetails with a number of other papers exploring the real-life consequences of powerful emotions. Another example is a St. George University study from earlier this year in which researchers show that loss, grief, and general “heartbreak” may double your risk of suffering a heart attack or stroke. “We often use the term a ‘broken heart’ to signify the pain of losing a loved one,” co-author Dr. Sunil Shah said. “Our study shows that bereavement can have a direct effect on the health of the heart.”

Similarly, another research team from the University of Chicago recently found that feelings of loneliness and solitude may increase your risk of premature death. A survey of older widows and widowers showed that the risk may increase by as much as 14 percent over the months following loss. According lead author John Cacioppo and colleagues, this means that loneliness as a mortality factor is almost as strong as socioeconomic hardship, which is typically taken to correspond to a 19 percent increase in the risk of early death.

While the biological foundation of these emotional effects remains cloudy, health experts are quick to point out that you can take steps to limit its impact — at least when it comes to anger. According to Maddock, it’s all about keeping cool. “Learning how to relax can help you move on from high-pressure situations,” she explained. “Many people find that physical activity can help to let off steam after a stressful day.”

Source: Mostofsky E, Penner AE, Mittleman MA. Outburst of anger as a trigger of acute cardiovascular events: a systematic review ad meta-analysis. European Heart Journal. 2014.