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Laughter, along with an active sense of humor, may help protect you against a heart attack, according to a recent study by cardiologists at the University of Maryland Medical Center in Baltimore.

The study, which is the first to indicate that laughter may help prevent heart disease, found that people with heart disease were 40 percent less likely to laugh in a variety of situations compared to people of the same age without heart disease.

“The old saying that ‘laughter is the best medicine,’ definitely appears to be true when it comes to protecting your heart,” says Michael Miller, M.D., director of the Center for Preventive Cardiology at the University of Maryland Medical Center, and professor of medicine at the University of Maryland School of Medicine. “We don’t know yet why laughing protects the heart, but we know that mental stress is associated with impairment of the endothelium, the protective barrier lining our blood vessels. This can cause a series of inflammatory reactions that lead to fat and cholesterol buildup in the coronary arteries and ultimately to a heart attack.”

In the study, researchers compared the humor responses of 300 people. Half of the participants had either suffered a heart attack or undergone coronary artery bypass surgery. The other 150 did not have heart disease. One questionnaire had a series of multiple-choice answers to find out how much or how little people laughed in certain situations, and the second one used true or false answers to measure anger and hostility.

Miller said that the most significant study finding was that “people with heart disease responded less humorously to everyday life situations.” They generally laughed less, even in positive situations, and they displayed more anger and hostility.

“The ability to laugh—either naturally or as learned behavior—may have important implications in societies such as the U.S. where heart disease remains the number one killer,” says Miller. “We know that exercising, not smoking and eating foods low in saturated fat will reduce the risk of heart disease. Perhaps regular, hearty laughter should be added to the list.”

Miller says it may be possible to incorporate laughter into our daily activities, just as we do with other heart-healthy activities, such as taking the stairs instead of the elevator. “We could perhaps read something humorous or watch a funny video and try to find ways to take ourselves less seriously,” Miller says. “The recommendation for a healthy heart may one day be exercise, eat right and laugh a few times a day.”

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