Q: I am a 29 years old short-tempered man. I am used to day-dreams full of anger like fighting with someone, beating someone and I cannot stop it. I smoke regularly too. Can anger be the cause of hypertension and is there any connection between the two? I have checked my blood pressure and it is normal. Please advise.

A:Anger and blood pressure are not always related but it is possible that if you continue to have anger problems you may develop high blood pressure (hypertension). Anger may lead to several secondary problems if not properly addressed. Specifically, it may disrupt your social and occupational life as well as lead to legal problems. As such taking motivation to get it resolved or controlled may help you in the long run. Additionally, it is known that individuals with chronic anger problems are at higher risk for heart diseases/heart attacks and other cardiovascular problems, depression, suicide, etc. In any case, anger could be a result of several underlying problems including depression, bipolar disorder or in some cases certain anxiety disorders. If these major emotional problems are ruled out, there are other disorders which primarily manifest as anger or impulsive urges either to verbalize anger/scream or physical expression of anger, often precipitated by stimuli which otherwise would not cause anger in an healthy individual.

To get assessed further in this regard, I suggest that you see a psychiatrist. In addition, you might want to journal (write) the triggers that lead to anger in you - for this keep a journal and every time you have an episode of anger outburst, note down what happened prior to and during the anger episode - note down any trigger, the thoughts that went through your mind (such thoughts may be difficult to realise initially but as you get aware you will be able to easily realize what you were thinking prior to and during such an episode of anger). Once you start keeping this journal, then look at the situations that led to anger episodes objectively by reviewing the journal. This may give you some insight in to what triggers/thoughts lead to anger in you, which will help you understand yourself better and possibly help you in decreasing your anger. Some other things to be aware of that may cause anger are - 1) lack of assertiveness - that is in ability to express your feelings and opinions clearly and firmly may also lead to anger - if this were the case you may benefit from a type of training called as "Assertiveness Training". 2) Poor social skills - which again can be improved with training.

In any case the first step would be to get evaluated by a psychiatrist.