Stress & Heart Health

The idea that too much stress makes you sick is one to take to heart. Stress can pave the way to heart disease, and after a tragedy or shock, stress can even cause a fleeting, frightening heart syndrome.

Stress 101

Stress is a response to the varied demands of daily life, from missing the bus to learning a friend is dying. How we “feel” stress can be very different from the next person. This experience is communicated between the brain and the neurological, endocrine, and immune systems—and the heart.

Broken heart syndrome

In the early ’90s, a novel cardiac syndrome known as “takotsubo cardiomyopathy” was first reported in Japan and eventually provoked great interest from cardiologists worldwide. The hallmark of this condition is the heart assuming a bulging, balloon-like shape similar to an octopus trap, or takotsubo.

You may know this condition by its more common name: broken heart syndrome. Symptoms are typically triggered by profound emotional or physical stress, giving rise to this nickname.

The loss of a loved one, serious financial problems, a car accident, and domestic abuse are examples of triggers. The intense grief or anger experienced by those suffering from a “broken heart” causes a release of stress hormones that stun the heart and impede blood flow to the body, resulting in symptoms similar to a heart attack.

These symptoms include

• chest pain or jaw pain
• shortness of breath
• fatigue
• feeling lightheaded or dizzy
• nausea
• cold sweat

Seek medical attention if you experience any of the above symptoms. You can’t know for certain what you’re suffering from without tests.

Broken heart syndrome is most prevalent in older, postmenopausal women. It has been suggested that endothelial dysfunction (abnormal behaviour of the inner lining of blood vessels), worsened by lowered estrogen levels, may influence heart spasms or stunning.

Interestingly, broken heart syndrome is temporary with no evidence of blocked coronary arteries (as seen in heart attacks), and a quick and full recovery usually follows.

Stress and heart problems

Broken heart syndrome isn’t the only effect of stress on the heart, nor is it the most serious. Ongoing strife and failure to resolve negative emotions may lead to arrhythmias (irregular heartbeats) and even accelerate atherosclerosis (hardening and narrowing of arteries).

Emotional triggers such as fear, anxiety, and sadness have also been shown to precipitate cardiac events. The underlying source of stress can vary.

Bereavement

Research shows that the risk of experiencing cardiovascular incidents increases in the months following the death of a spouse.

Trouble at work

Chronic work-related stresses such as high demands or low salary pose a two- to three-fold higher risk for cardiac events, according to some researchers.

Seeing red

Research shows there is a higher rate of cardiovascular events in the two hours following angry outbursts.

Psychosocial stressors

Findings from the UK’s Whitehall II study, which followed several thousand London-based civil servants since 1985, revealed that those who believed stress impacted their health “a lot or extremely” had double the risk of heart attack compared to those who believed it didn’t.

Stress and survival

Of course, stress doesn’t always cause a bulging heart or life-threatening cardiac event. In fact, it can sometimes be a positive force resulting in better performance— at a job interview or music recital, for example.

More often, however, stress is perceived as an unpleasant experience that demands attention, and with good reason: our response to stress can ensure our survival.

Maintaining a constant internal balance in the face of a changing environment is critical to sustaining life— a concept known as homeostasis. The “fight-or-flight” response is a survival mechanism. It is designed to maintain homeostasis by preparing the body to kick into gear when faced with a threat.

During a stressful event, a carefully orchestrated sequence of hormonal, cardiovascular, and other physiological changes occurs. Heart rate increases, blood pressure elevates, and energy stores are made available.

But what happens if those changes go on for too long?

Acute versus chronic stress

Stress is considered acute when it’s brief or transitory. Even short-lived, minor stress can have an impact. For example, your heart may race before giving a speech. More major acute stress, such as that caused by an earthquake, exerts a greater impact.

Acute stress responses in healthy individuals increase resiliency and resistance to short-term stress. But stress that lasts for prolonged periods can become chronic and lead to adverse health outcomes such as diabetes, major depression, low immune function, and heart disease.

When the heart is exposed to elevated stress hormones such as epinephrine for long periods, damage to the arteries and blood vessels can occur, along with increases in blood pressure and heart rate, as well as a higher risk of heart attack or stroke.

Stress-busting tips

The good news is that you can put the brakes on stress by tapping into your body’s relaxation response using a variety of techniques.

Mindfulness

Try meditation, yoga, tai chi, breathing exercises, or prayer. Mindfulness allows you to experience calmness, focus, clarity, and general mental well-being.

Exercise

Do some form of daily exercise. This releases mood-elevating endorphins and helps to “work off steam” when you’re feeling agitated or angry.

Diet

Eat more fruits and vegetables. The higher levels of vitamin C in citrus fruits and leafy greens provide protection against heart disease by lowering blood pressure and cortisol, a stress hormone.

Lifestyle

Avoid heart-harming behaviours such as smoking, physical inactivity, and alcohol consumption.

Support

Build a strong network of family and friends. Discussing problems and expressing feelings reduces conflict and the stress associated with it.

Enjoyment

Make time for enjoyable activities daily. A lower perceived level of life enjoyment has been linked with higher risks of cardiovascular disease incidence and mortality, particularly in men. a

Men are from Mars …

When it comes to coronary events in relation to stress, men and women may not be created equal.

A 2006 study showed that hardening of the arteries is more frequent in women when they and their husbands express hostility during marital disagreements, but more common in men when they or their wives are controlling.

According to a 2014 study, men showed more changes in blood pressure and heart rate in response to stress, while women exhibited decreased blood flow to the heart and an increase in the beginnings of blood clot formation.

Try adaptogens

Botanical medicines categorized as “adaptogens” have been shown to improve your body’s response to and recovery from stress.

Siberian ginseng is one such adaptogen, with evidence pointing to its ability to help the body accommodate adverse physical conditions and improve mental performance.

Ashwagandha is a favourite from the Ayurvedic tradition. In tests on animals, it has been shown to counteract changes in blood sugar levels and improve depressive behaviour associated with extreme stress.

Rhodiola rosea is an anti-stress superstar with an affinity for protecting the heart from arrhythmias and other damage caused by elevated stress hormones. It has also shown improvements in sleep disturbances, fatigue, and general well-being.

Always consult your health care practitioner before taking supplements to ensure they are right for you.