Getting really angry might be more dangerous than you think.

A new study found people who experienced severe anger outbursts were more at risk for cardiovascular events in the two hours following the outbursts compared to those who remained calm.

“The relative risk was similar for people who had known pre-existing heart disease and those who didn’t,” says Dr. Murray A. Mittleman, senior study author and an associate professor of medicine at Harvard Medical School.

The study was designed so that each patient was compared to his or her own baseline risk. “A person with pre-existing heart disease or cardiovascular disease, the absolute risk they are incurring is much greater than (that of) a person without cardiovascular disease or risk factors,” Mittleman says.

“If we look at somebody at higher risk for having cardiovascular events, and they get angry multiple times a day, this can lead to 650 extra heart attacks per year out of 10, 000 a year,” he says. “When we look at a person who is relatively low risk, but if they do have these episodes of anger fairly frequently, we estimate there would be about 150 extra heart attacks out of 10,000 a year.”

Smoking, high cholesterol, high blood pressure, being overweight and having diabetes are all risk factors for cardiovascular disease. An estimated 17 million people worldwide die of cardiovascular diseases, particularly heart attacks and strokes, each year, according to the Centers for Disease Control and Prevention.

The study published Monday in the European Heart Journal was a data analysis looking at nine studies where anger and cardiovascular events were self-reported over nearly two decades.  The study found a 4.74 times higher risk of MI (myocardial infarction, or heart attack) or ACS (acute coronary syndrome, where the heart muscle doesn’t get enough oxygen-rich blood) following outbursts of anger.

“Anger causes our heart rate to increase through the sympathetic nervous system and causes our stress hormones to become elevated (the fight or flight mechanism),” says Dr. Mariell Jessup, president of the American Heart Association and medical director of the Penn Heart and Vascular Center at the University of Pennsylvania. “We breathe faster, all of which may trigger undesirable reactions in our blood pressure or in our arteries.”

This disruption may mean the heart or the brain doesn’t get the blood and oxygen they need resulting in a heart attack or a stroke, she says.

Researchers suggest more needs to be done to come up with effective interventions to prevent cardiovascular events triggered by anger outbursts. The American Heart Association suggests regular physical activity, finding a way to relax or talking with friends to help reduce stress and anger.

Mittleman suggests the best way to lower your risk for a heart attack or stroke during an angry outburst is to lower your overall baseline level of risk – exercise, eat healthy and don’t smoke – and then find ways to cope with stress and anger.

By Eliana Dockterman

Matthew Breuer has shared the passwords to his computer, email and social media accounts with every girlfriend he’s ever had. It’s a matter of convenience — she can check his email when he can’t access it or get into his phone to change the song playing on the speakers. But it’s also symbolic.

“I feel like it’s so much easier to live in a relationship where you know you have nothing to hide and are entirely 100 percent honest about who you are and what you’re doing,” he says. “Times in my life when I’ve realized that something wasn’t working in my relationship coincided with times when I would be worried, ‘Oh, do I really want to say this on Facebook to somebody else?’ It’s such a red flag if there’s something you’re concerned about your partner seeing. That means there’s some fundamental issue with your relationship beyond privacy.”

Breuer, a 22-year-old student at Yale University, has most American couples on his side. According to a recent Pew study, 67% of Internet users in marriages or relationships have shared passwords to one or more of their accounts with their partner.

Though we don’t feel comfortable exchanging passwords with perhaps more trustworthy family members and long-term friends, we do feel comfortable exchanging access to our personal information with boyfriends and girlfriends. It’s an exercise in trust, the logic goes. If you have nothing to hide, why would you want to hide your password? And, as Breuer point out, knowing someone may look over your shoulder can keep you honest.

For Jasmine Tobie, a 29-year-old graduate student at the University of Oklahoma in Tulsa, seeing someone else’s transgressions via email has saved them from a toxic relationship. After finding some receipts that proved her boyfriend was lying to her about being on a business trip one weekend, she decided to look at his email to be sure before she pulled the plug on the relationship. “Once I found that I just had to have more evidence.”

She didn’t know his password, but was able to guess correctly using clues on his desktop. “He was still ‘communicating’ with his exes. He had taken a trip to visit an ex and told me it was a work trip. He was still signed up with dating sites and other ‘hookup’ sites and actively communicating with those people…I found some pictures of him and people he swore were ‘friends’ in the act.” The two had dated for a year and lived together for about nine months. “I was trying to find some way to give him the benefit of the doubt. In the end, it did clarify for me that he was not it for me at all and that there were issues I couldn’t fix.”

Tobie says those were extraordinary circumstances, and she wouldn’t read someone else’s emails again. She doesn’t share passwords with her current boyfriend.

In most circumstances, psychologists suggest keeping passwords private.  ”In relationships, we depend on each other for a lot of things, but it’s good and healthy to have some independence too,” says Kelly Campbell, PhD, an Associate Professor of Psychology at California State University. “The more you self-disclose, the happier you are. But the happiest couples have some degree of secrecy and privacy.”

Unsurprisingly, sharing passwords can cause some serious problems during a relationship or after it ends.

Rosalind Wiseman, author of Queen Bees and Wannabes — the book that inspired Mean Girls — advises the teens she talks to for her research to not share passwords because “the relationships can change so quickly, and the emotions behind the breakups can be so strong.” She says that one high schooler she worked with was blind-sided when his ex-girlfriend found his phone. “She knew where he charged his pone during class and knew his password, so she went in and sent all sorts of texts to friends, to another girl he was talking to — it really created a lot of problems for him.”

Though one might assume that teens and 20-somethings are the ones foolishly sharing passwords — and suffering from the resulting drama — the survey found that the practice of password-sharing is pretty equal across age groups, and that 18-29-year-olds were actually the least likely to share passwords. Sixty-four percent of 18-29-year-olds share passwords, compared with 70% of 30-49-year-olds, 66% of 50-64-year-olds, and 69% of those over 65.

And you don’t have to be a teenager to have password problems with your significant other. Suzy*, a 46-year-old mother living in Brooklyn, got into a dangerous situation years ago when her then-boyfriend started reading her emails. She hadn’t given him her password, but one day she forgot to log out and he checked her email. The couple had been on-again-off-again, and she hadn’t told him that she had created an online dating profile while they were apart. She had since deleted the profile and deleted most of the email exchanges with the men she met through the site. “But he went through all my emails, including ones that I had thrown away. He went into every folder. He got really mad and basically attacked me,” she says. “I ended up having to call an ambulance.”

Since, she says she’s never even considered sharing passwords with a significant other. “I now have this paranoia where I wouldn’t even share it even if I trusted someone. You never know what’s going to upset someone,” she says. ‘I don’t know if that makes me less trusting or just wiser.”

Still, optimists like Breuer are undeterred by such horror stories. Breuer says he has always developed friendships with the girls he has dated before dating, and therefore felt they could be honest with one another. ”I think sharing passwords honestly ends up affording you the privacy you want,” Breuer says, pointing to a password etiquette that has developed between him and his partners in recent years. “Just because you tell somebody your password to things doesn’t mean they actually end up looking through your stuff.” Breuer says he’s never changed his password after a breakup since he’s always trusted and respected those he has dated.

Campbell says the best way to determine if you’re ready to share passwords with your significant other is to check and see if you’re on the same page. “If you have any question in your mind, the answer is no,” says Campbell. “I would say that it should be reciprocal. You shouldn’t be sharing something if your partner also didn’t share it…People are happiest when they have a match. You and your partner should be a match in that respect too.”

But much of the tough negotiating about privacy goes out the door once you have kids. “Sure, a lot of people have found out about their significant other’s indiscretions by looking at the texts on that person’s phone,” says Wiseman. “But once you have children, the constant checking of logistics with the other person to just get through the day—to get everyone to basketball practice on time—blows all of this privacy stuff out of the water.”

Interestingly, the attitude about privacy seems to change when it’s the child’s, not the partner’s, text messages in question. Both Wiseman and Suzy admitted that they’ll often try to figure out their children’s passwords or have their kids show them text exchanges to make sure they’re not getting into any trouble.

But presumably, by 18, you’ve earned the right to some privacy if you choose to have it.

By Alexandra Sifferlin

Here’s a scenario you might recognize if you’re a woman dating a social media butterfly: You’re sitting on the couch together silently watching TV. When you take a moment to peek at your Twitter feed, you see your significant other has been sharing a stream of personal thoughts about House of Cards with the Twitterverse—even though he hasn’t uttered a word to you.

It’s no surprise that men tend to be more tight-lipped than women about their thoughts and feelings, but social media is creating a haven for some men to express themselves online in ways they don’t in person—and never would have before. From a relationship perspective, that can be a good and bad thing. Women can now turn to social media to get more insight into what their partners think, but where’s the intimacy in that when those feelings are also being broadcast to hundreds of Facebook friends and thousands of Twitter followers?

Recent data from Pew Research Center suggests that social media is making its way into relationships more than ever, with 74% of couples surveyed saying the Internet has impacted their relationship in a good way. Women are more likely than men to use social media, with 71% of women participating compared with 62% of men, according to the latest report from Women’s Media Center. However, what psychologists and researchers find especially interesting is that, while women are equally willing to share the the thoughts they spew out into the digital ether with someone face to face, men are much less likely to do the same.

Eva Buechel, a PhD candidate at the University of Miami who has studied why people share content online, has found that men and women who experience social anxiety, and therefore have a greater need to express their negative emotions and seek support, are equally likely to maintain a blog or social media account. However, “while socially apprehensive females share equally across different communication channels—face to face or microblog—males seem to show a very strong preference for microblog,” Buechel says. Introverts also find it easier to share their thoughts online than in person.

Other research from Northwestern University shows that men are increasingly more likely to share their creative work, like writing, music, or art, online. Nearly two-thirds of men in a 2008 study said they post their work online, compared with only half of the women who reported posting.

Females, of course, are well versed at expressing their feelings. “Women usually have close and intimate friendships, which might make it easy to approach a friend when they need to talk to someone,” says Buechel. “Men have different relationships with their friends, and they might find it more difficult to approach someone in particular to talk to when they need someone to listen or comfort them.”

Such friendship dynamics can contribute to men feeling more apprehensive about expressing themselves when it comes to real, rather than digital, life. “When men are texting, emailing, or communicating through another technological channel, they feel less threatened and are more likely to share their thoughts and feelings because they don’t have to deal with the reaction from the other person in-person, in real-time,” says Dr. Seth Meyers, a Los Angeles psychologist.

That’s one reason Avidan Ackerson, 28, a software engineer in New York with three different Twitter accounts, tends to share more personal things on Twitter than he does on Facebook. “I don’t necessarily always want someone who knows me well to know things about me, but I want someone to know these things,” he says.

Ben*, 28, who works in commercial real estate finance in New York City and tweets as much as 50 times a day, has yet to reveal his Twitter handle to the woman he’s been dating for a month, even though he tweeted about their first date shortly after it happened. “It’s not something I am embarrassed to share, but it’s a level of intimacy we have not yet achieved in real life,” he says. And it will probably be months before they become Facebook friends.

“Connecting online offers men the illusion of security, even though it often causes frustration later among their dates who are wondering, ‘Why is he different and more closed when we’re actually together?’” Meyers says.

Though frustrating for women who prefer face to face communication with their mates, social media may offer a halfway point. “Men are not very good communicators,” says Michael Busby, 47, a system programmer and lecturer at Murray State University in Murray, Kentucky, and an avid blogger. “When we get frustrated, we really start to break down. There are times when [I get overwhelmed in the classroom], I start to stutter. I have to calm down. But a controlled environment encourages us to have more confidence.”

Jessica Riches, 23, a social media consultant in London says her boyfriend, who tweets constantly, is pretty good at communicating. But visiting his Twitter page and seeing everything from his day-to-day activities to his thoughts and feelings can make her feel closer to him as well. “I look at it more regularly [when] I miss him and wonder what he’s up to.”

Still, for a woman from Venus and a man from Mars, there’s something frustrating about a man’s willingness to communicate with thousands of people—some friends, some strangers—in a way he can’t seem to do with the person lying right next to him in bed.

*Name has been changed for privacy.

By Alexandra Sifferlin

Biggest Loser winner Rachel Frederickson shocked audiences Tuesday when she revealed she had dropped 155 pounds, nearly 60% of her starting weight. Earlier this week a Saudi man also made headlines for losing an astronomical 700 pounds, shedding 50% of his original weight. With the success of shows like The Biggest Loser, Extreme Makeover, and My 600-lb Life, extreme weight loss has become somewhat of a gawking pastime among American audiences. But while audiences can witness these people’s external changes in appearance, what’s happening internally when a body shrinks to half its size?

Obesity is typically measured by body mass index (BMI), with a BMI of 30 and above considered obese, and BMI of 40 and above considered severely obese. For people with a BMI above 40 to reach a healthier weight and actually maintain it, weight-loss surgery is usually the only option. For a 5’10? man, that’s about 280 pounds, and for 5’5? woman, approximately 240 pounds.

Once the pounds start shedding, people’s perception of their own size remains skewed while they internalize their new bodies. As they adjust, they continue to make a lot of space for themselves, like selecting large spaces to sit. ”Internally, people still think they are large. They swing their arms further out from their body like a helicopter, thinking their hips are still as wide as they used to be, even though they aren’t,” says Dr. Roxanne Sukol, a preventive medicine specialist at Cleveland Clinic.

The first 25 to 30 pounds are the easiest to drop, and usually accompanied by immediate improvements in blood pressure, blood sugar, and breathing. It becomes harder to lose the pounds after that initial period, but with each additional pound lost, physicians notice improvements in virtually every organ system.

However, if an individual’s weight has caused significant health problems, like heart issues or diabetes, such problems don’t go away so easily. Even when a person recovers, ailments developed along the way can remain. “We see blood pressure and sugar improve rapidly, but if your obesity caused you to have a dilated heart, that might take longer to heal–if it ever heals,” Dr. Sukol says. Excess skin can also remain after weight is dropped, but it usually adapts to the body after a period of time.

Physical therapy is nearly always needed to continue the healing process. If an individual has not been mobile for years, their muscle and skeletal systems are likely damaged. Our knees and lower extremities aren’t meant to hold the amount of weight severely obese individuals carry, and that weight can interfere with blood flow to the heart, which is one of the reasons obese people experience bloating. The good news, according to Dr. Sukol, is that, with every five pounds lost, an enormous amount of pressure on the knee caps is relieved.

Appetite can also change. When individuals replace foods like white breads and potato chips with intact carbohydrates like beans, vegetables, fruits, and whole grains, they tend to lose weight and feel more satiated from eating more nutritious food.

Lastly, the mental health effects that come from significant weight loss are immeasurable. From a biological level, neurotransmitters in the brain work better when a person is on a healthy diet. But socially, the effect of weight loss is just as great. “Being obese is such a stigma in our society, that I think the stress of being obese and having to cope with how people look at you is something impossible to relate to,” says  Dr. Sukol. And that’s a considerable weight off someone’s shoulders.

The American Heart Association outlined Thursday its first ever guidelines for primary care provider sand OBGYNs developed specifically to prevent women’s strokes, the third leading cause of death for U.S. women, and the fifth leading cause for men.Stroke risk factors for both men and women include high blood pressure, high cholesterol, and smoking, but certain hormonal changes can reportedly increase a woman’s risk.

“If you are a woman…your risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors,” said Cheryl Bushnell, M.D., M.H.S., author of the new scientific statement published in the American Heart Association journal Stroke.

According to the guidelines, women with a history of high blood pressure before pregnancy are at risk for preeclampsia, a blood pressure disorder that occurs during pregnancy. Preeclampsia doubles the risk for stroke and increases the risk for high blood pressure four-fold, according to the guidelines.

The combination of high blood pressure and birth control use can also raise a woman’s risk for stroke. Migraines with aura, diabetes, depression, and emotional stress, which occur more frequently among women, are also contributing factors.

Many of us in the healthcare field have preached for decades that people should not rely on vitamins in pill form to meet the recommended doses of vitamin intake. Instead, we’ve urged our patients to get their nutrients from the foods we eat.

Now, however, a certain population of women may have an important reason to take multivitamins. New research data, which were extracted from the Women’s Health Initiative Clinical Trials and the Women’s Health Observational Study, show that older women with invasive breast cancer—cancer that has spread outside of the breast duct—may gain a new advantage from taking a multivitamin each day; in fact, these vitamins may reduce the risk that their breast cancer will recur.

Wow.

That’s right. This research, recently published in the journal Breast Cancer Research and Treatment, suggests that multivitamin/mineral supplements may help older women who develop breast cancer to survive their disease.

Multivitamin/mineral supplements are the most commonly consumed dietary supplements among adults in the U.S. They usually contain small amounts of 20 to 30 vitamins and minerals, often at levels reaching 100 percent of U.S Recommended Dietary Allowances or less. The manufacturers of these products recommend that people take one pill daily.

A comparison of those who took a multivitamin and those who didn’t

Fortunately, these two studies were large enough so that the results of this new vitamin-and-mineral research were valid.

During the extensive study period, 385 of the women diagnosed with breast cancer during the study were using supplements. The vast majority of these had been taking the supplements prior to being diagnosed. A comparison of mortality rates revealed that the women with invasive breast cancer who took multivitamins/mineral supplements were 30 percent less likely to die from their cancers than were the women with invasive breast cancers who hadn’t taken any supplements.

Could merely taking these supplements explain the difference in these statistics? Well, the researchers then also looked at all the other potential possibilities such as smoking history, race, ethnicity, age, depression, diet, alcohol use, physical activities, age at diagnosis of breast cancer, and diabetes. And after considering all these other factors with due diligence, the scientists concluded that the supplement usage was what made the difference in the mortality rates.

But you still must eat nutritious foods!

Now, here comes my regular caveat: Please don’t interpret these research results to mean that you can stop eating a healthy diet and rely solely on a supplement pill to assure that you are getting the nutrients you need. Instead, consider clipping a coupon for a multivitamin from the Sunday paper this week and start taking one, especially if you are over age 50, have had breast cancer, and have a chance of recurrence.

There isn’t research yet to determine if taking this pill prevents breast cancer in those not diagnosed, but research is certainly underway to try to decipher this as well.

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