Those who like to physically work out their stress may want to change their plans, with a new study finding intense exercise while emotionally upset could trigger a heart attack.
The study, published in American Heart Association's Circulation on Tuesday, examined more than 12,000 people across 52 countries.
It found being upset or angry more than doubles the risk of a heart attack within the hour.
Heavy physical exertion had the same result.
But when they were combined, with someone exercising strenuously while upset, the risk was more than triple.
"Both [physical and emotional triggers] can raise blood pressure and heart rate, changing the flow of blood through blood vessels and reducing blood supply to the heart," says lead author Dr Andrew Smyth.
"Regular physical activity has many health benefits, including the prevention of heart disease, so we want that to continue.
"However, we would recommend that a person who is angry or upset who wants to exercise to blow off steam not go beyond their normal routine to extremes of activity."
Previous studies had been focused on only one country or region, meaning this study better examines triggers that are similar amongst different cultures.
American Heart Association volunteer Dr Barry Jacobs says the report shows evidence of a "crucial link" between body and mind.
"Excess anger, under the wrong conditions, can cause a life-threatening heart attack. All of us should practice mental wellness and avoid losing our temper to extremes."
Instead of exercising hard, he suggests people already at risk to heart attacks find other methods of coping with emotional upset.
"One way many cope with the emotional ups and downs of a health condition is through peer support, talking with others who are facing similar challenges can be very helpful in better managing your own emotions."