How often have you heard the advice to not to keep any anger in for the sake your health? There’s a common notion that suppressing your anger must be bad for your body, or at least give you a stomach ulcer. From time to time you read reports showing that it could be bad for your heart. But when you look across the evidence that has built up over the years, what does it reveal about managing anger?

In terms of ulcers, whether you storm around the room raging or simmer in silence, you can still get them. While stress was thought to be a major contributing factor, there’s no clear evidence that it depends on whether or not you express your anger, as it’s now known that most ulcers are caused either by the bacteria Heliobacter pylori or by prolonged use of non-steroidal anti-inflammatory drugs.

When it comes to the heart, the evidence is more mixed. In a study carried out at the University of North Carolina in 2000, 13,000 patients were given questionnaires in which they rated their own tendency to get angry, and were followed up a few years later. Although their blood pressure was apparently normal, those who had said they frequently lose their temper were three times more likely to have had heart attacks in the intervening years than the others, even when factors like smoking, diabetes and weight had been taken into account. Likewise, Mark McDermott from the University of East London found that people who expressed their anger suffered more from heart disease than those who held back from shouting.