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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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What a Difference
60 Minutes Can Make
It’s just an hour. At 2 a.m. on March 14, time changes as we “spring forward” one hour overnight. It wouldn’t seem to be that big of a deal, but it is according to researchers at the University of Michigan’s Center for Sleep Science. They have found that in the days immediately following the spring time change each year more people have serious car accidents, most likely due to the sleep loss and adjustments that our biological clocks must make to the new schedule.
To prepare for the time change, start going to bed and waking up 15 minutes earlier each day between now and the start of Daylight Savings Time. This helps reset your biological clock.
The spring time change isn’t the only time we should be concerned about our levels of sleep. According to the sleep researchers, adults ought to get 8 to 8.5 hours of sleep every night, but few of us do. This does more than leave us groggy in the mornings. Findings have shown that a lack of sleep may increase risks of obesity, diabetes, stroke and heart attacks.
The National Sleep Foundation offers this advice for healthy sleep:
