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Stress, unabated, can kill you. The stressed heart was meant to aid the body in evading the occasional saber-toothed tiger, volcano eruption or dashed-upon-the rocks romance. It was not meant to sustain extended periods of adrenaline surges.
Case in point: Enron founder, the late Ken Lay.
Numerous research studies (too stressful to count) validate that stress, hostility and depression are as risky to the heart as runaway blood pressure, bad genes and high cholesterol.
"Chronic stress, helplessness and hopelessness place you at high cardiac risk," says cardiologist Samuel Ward Casscells, III, the John Edward Tyson Distinguished Professor of Medicine and Public Health at The University of Texas Health Science Center at Houston.
When the body is under extreme stress, Casscells explains, it releases adrenaline and cortisol, which have negative effects. Suddenly, the arteries constrict, the blood gets thicker and is prone to clotting. The heartbeat accelerates which can outstrip the blood supply and the irritability of the heart is increased, "giving way to arrhythmia, the threshold for defibrillation. These hormones eat away at the body like acid," Casscells says.
Smart men centuries ago knew this. In the New Testament's The Gospel According to St. Luke, he describes "men's hearts failing them for fear," Casscells relates.
Dr. John Hunter, the Surgeon General of the English Army in 1790, realized there was something wrong in his chest when he was angry. He once said, "My life is in the hands of any fool who manages to put me in a rage." In fact, at a St. George's Hospital board meeting in London in 1793, Hunter became angry, had a heart attack and died.
"In an evolutionary sense, all of these primal reactions were okay. When our ancestors were being chased by a lion or someone with a spear, it meant they could outrun the enemy. If they were cut, the loss of blood was reduced because it was thickened by the hormones, which also constricted the arteries to reduce bleeding and to maintain blood pressure," Casscells explains.
"The hormones also promoted alertness. But adrenaline is maladaptive for our current age because we do not settle disagreements with fight or flight. Today, we usually talk things out or walk away and seethe."
Some think adrenaline and cortisol are different for a healthy person as opposed to a person with heart disease. Some studies suggest that anger and anxiety are related to the development of coronary artery disease. People with heart rhythm problems are at particular risk for having their negative emotions trigger potentially fatal arrhythmias.
Reducing your anger while developing a forgiving attitude could have a positive effect on your heart, suggests another study at the University of Wisconsin. Patients with a high level of anger and a non-forgiving attitude related to a prior hurtful event were tested. Their reactions to stress while recalling the event were measured. Heart scans showed increased cardiac risk.
Those who completed an intervention to help them forgive the person who inflicted the pain revealed more positive coronary outcomes than those who did not.
Initial grief is particularly damaging to the heart, especially for widowed men. Data shows that in the first week after the loss of a spouse, the wife's risk of a heart attack increases sevenfold and for the husband, cardiac risk goes up 14-fold. The love that couples share grows with the passage of time. When that union is broken by death or the possibility of death, the stress on the other spouse can be equally destructive.
"I had a female patient who had a heart attack one night after she and her husband had gone to bed," Casscells recounts. " He had Lou Gehrig's disease (ALS /amyotrophic lateral sclerosis) and could not move to help her. The next morning when their daughter found them, they were both dead. Because of the stress of not being able to give his wife any assistance, he had a heart attack also, "Casscells surmises.
"Then there was the wife who came to be with her husband in the hospital right after he had suffered a heart attack. Upon seeing him, she had a heart attack, and she ended up in the same unit."
Casscells urges family members to be proactively supportive. "Talk about all the fun things that will happen in the future, and remember to talk about all the good things from the past. Talk about the funny things that happened during the day. Tell the parent how much you love them and need them."
Men, he says, particularly feel emasculated after a heart attack and need to be told that they are needed as well as loved.
"If it is the wife who is the patient, then I have to tell the husband he is expected to make the morning coffee. I want her to be relaxed and not jump out of bed because early morning is the most stressful time of day for the heart," Casscells says.
Early morning is when the adrenaline and cortisol levels go up. The blood gets thicker and the heart rate increases. Aspirin and beta blockers such as metoprolol, carvedilol, or atenolol, can help. Antidepressants can also be useful, he adds.
New findings show however that a certain amount of stress is not only good for you but triggers the expression of a pair of longevity genes. Resveratrol, found in red wine, also triggers these genes. The discovery was made by testing people who fast and restrict their caloric intake. This research is just beginning, says Casscells.
Whether you have heart disease or not, whenever you are running your "motor" hard, you are putting miles on it, Casscells stresses. The paradox is that for healthy hearts, exercise is good because it slows the heart rate after exercise.
Once you get in shape, your resting heart rate falls into a healthy range. Thirty minutes of exercise a day will get your heart and you into good physical condition, which will conserve heart beats. Exercise is one of the best ways to relieve stress, anxiety and depression.
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Cardiologist Samuel W. Casscells is the John Edward Tyson Distinguished Professor of Medicine at the UT Medical School.
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Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.
