All of us are under a steady state of stress in this fast-paced life. To understand the relationship between stress and cardiovascular diseases, we must first make it clear as to what kind of stress we are referring about. There are different kinds of stress; Physical and emotional stress being the two most important types that are most relevant to the heart.
Does stress cause your blood pressure to rise? Can stress cause you to have a heart attack? While differing opinions exist about these and other issues, research has shown that stress does play a role in many cardiovascular disorders.
Most of the medical literature on stress and heart disease refers to physical stress. But most people are referring to the emotional variety when they talk about stress.
Exercise or other forms of physical exertion places measurable and reproducible demands on the heart. This physical stress is generally acknowledged to be good. In fact, the lack of physical stress (i.e., a sedentary lifestyle) constitutes a major risk factor for coronary artery disease. So this kind of “stress” is usually considered to be good for the heart – as long as the heart is normal.
If there is underlying heart disease, however, too much physical stress can be dangerous. In a person who has coronary artery disease, for instance, exercise can place demands on the heart muscle that the diseased coronary arteries cannot meet, and the heart becomes ischemic (i.e., starved for oxygen.) The ischemic heart muscle can cause either angina (chest pain), or a heart attack (actual death of cardiac muscle).
In summary, physical stress is generally good for you, and is to be encouraged, as long as you have a normal heart. On the other hand, with certain kinds of heart disease, too much or the wrong kind of physical exertion may be harmful.
But either way, physical stress does not cause heart disease.
Emotional stress is generally the kind of stress people are talking about when they refer to stress causing heart disease. We would have heard of people saying “No wonder she suffered an attack, she was going through a lot”.
Everyone – even doctors – have the notion that emotional stress, if it is severe enough or chronic enough, is bad for you. Most even believe that this kind of stress can cause heart disease. But scientific evidence that it actually does so has been hard to come by.
Emotional stress and heart disease
There is a fair amount of circumstantial evidence that chronic emotional stress can be associated with heart disease and early death.
Several studies have documented that people without spouses die earlier than married people. (While some might claim this constitutes evidence that emotional stress is actually good for you, most authorities agree that having a spouse actually provides a significant degree of emotional support and stability.) Other studies have shown fairly conclusively that people who have had recent major life changes (loss of a spouse or other close relative, loss of a job, moving to a new location) have a higher incidence of death. People who are quick to anger or who display frequent hostility have an increased risk of heart disease.
So emotional stress is bad, right? It didn’t start out bad. Evolutionarily speaking, emotional stress is a protective mechanism. When our ancestors walked over a rise and suddenly saw a saber-tooth tiger 40 yards away, a surge of adrenaline prepared them for either fight or flight as they considered their options.
But in modern times, now that saber-tooth tigers are few and far between, most often neither fight nor flight is the appropriate reaction to a stressful situation. (Neither fleeing from nor punching your annoying boss, for instance, is generally considered proper.) So today, the adrenaline surge that accompanies a stressful situation is not channeled to its rightful conclusion. Instead of being released in a burst of physical exertion, it is internalized into a clenched-teeth smile and a “Sure, Mr. X, I’ll be happy to fly to Delhi tomorrow and see about the new project.”
It appears that the unrequited fight-or-flight reaction, if it occurs often enough and chronically enough, may be harmful.
While our knowledge about stress and cardiovascular diseases is incomplete, most experts agree on the following points:
- Stress does contribute to heart disease in certain individuals.
- Stress also contributes to high blood pressure, high cholesterol, and other cardiac risk factors (e.g. smoking, overweight, etc.) in many individuals.
- Whether or not stress caused your illness to occur, suffering a heart attack or other cardiac condition is itself quite stressful for most individuals and their families.
Thus, if you’ve recently had a heart attack, stroke, or other cardiovascular condition, it is reasonable to assume that stress may have played a role in causing your illness to occur.
But when do you know that stress has actually taken a toll on you. When you are exposed to long periods of stress, your body gives warning signals that something is wrong. These physical, cognitive, emotional and behavioral warning signs should not be ignored. They tell you that you need to slow down. If you continue to be stressed and you don’t give your body a break, you are likely to develop health problems like heart disease. There are at least hundreds of physical, mental, emotional and behavioral warning signs and signals.
Recommendations
Stress management techniques may be quite helpful in reducing the risk of coronary events, and have the added benefit of being risk-free. Thus, there seems to be little reason not to recommend some form of stress management in people with heart disease, or with risk factors for heart disease. And finally, it should be pointed out that exercise is a great way of reducing chronic stress, and in addition has the advantage of directly lessening the risk of coronary artery disease, and helping to control obesity.
