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Stress-related cardiovascular diseases
When the body’s stress response is turned on, your body releases a cocktail of hormones which speed up your heart rate and cause many other physical side-effects.
Although these reactions may be useful in really dangerous situations, when dealing with intense or long-lasting stress and anxiety, they may have a negative impact on health and well-being, particularly on cardiovascular system.
Sudden onset of a racing or pounding heartbeat, irregular rhythms, "skipped" heartbeat, choking and shortness of breath and an overwhelming fear of having a heart attack are the most common manifestations of stress, anxiety and other negative emotions on the cardiovascular system.
However, it is good to know that stress and anxiety are not normative concepts, nor are they diseases in themselves. Although your stress and anxiety are not imaginary, no standard lab tests are available to confirm or measure them. Yet you feel them, and therefore you are best positioned to assess whether or not you feel stressed or anxious.
When stress and anxiety become very intense or chronic, they can impact the somatic (physical) health of your heart and circulatory system. As the nervous system modulates the physiological functions including the cardiovascular system, and the brain takes into account the emotional state in all that it does, the strong emotions always end up having an impact not only on the mood and behavior, but also on the proper functioning of the cardiovascular system and on the etiopathogenesis of all kinds of cardiovascular health issues.
Emotions are not just mental states and emotional feelings. Today's view of emotions is that emotions are experienced at four different, but closely interrelated levels: the mental or psychological level (the brain), the physiological level (the chemistry of your body), the somatic level (bodily emotional feelings), and the behavioral level. These complementary aspects are present in all human emotions, even in the most basic ones like stress, fear and anxiety.
The scientific study of emotion and of the bodily changes that accompany diverse emotional experience, known as psychosomatic medicine, marks a relatively new era in medicine. The central concept of psychosomatic medicine is the scientific fact that mind and body are integral aspects of all human function. The term ‘psychosomatic disorder’ is used for a physical disease that is thought to be triggered, made worse or caused by emotional factors. To an extent, most diseases are considered psychosomatic, as there is an emotional aspect to every physical disease.
Stress and anxiety induced hyperactivation of sympathetic nervous system leads to an increase in heart rate, blood vessel tone, myocardial oxygen consumption, activation of the renin-angiotensin system and increase in oxidative stress. Persistent stress and anxiety lead to psychological modulations, such as anxiety disorders, panic attacks and depression, which are also closely associated with the pathogenesis of cardiovascular diseases. Stress, anxiety and depression are accepted as even stronger risk factors for myocardial infarction than other traditional risk factors.
When considered from the perspective of the cardiovascular system, high glucocorticoid levels induced by stress play an especially important role in hypertension, insulin resistance, hyperglycemia and weight gain. Since glucocorticoids play active role in inflammation, the connection between high glucocorticoid levels and atherosclerosis can be established easily. Various studies suggest that treatments that reduce psychological distress improve the long-term outlook in people with heart disease. Evidence indicates that stress management programs may significantly reduce the risk of heart attacks in people with heart disease.
As you already know, rather than passively observing what happens to you, your subconscious mind is actually in charge of the proper functioning of your conscious mind and your body through the regulatory mechanisms of your autonomous nervous system. When you feel relaxed and safe, the sympathetic branch of the autonomous nervous system kicks in and your body is nourished, healed and energy is restored. Whenever you are facing a threat, the parasympathetic branch of the autonomous nervous system kicks in and the stress response will mobilize all your resources for your survival inbuilt fight or flight response.
While you are in the middle of a stress response, the stress response will mobilize all your resources for your survival, and your body's nourishing, restorative, maintenance and self-repair functions come to a screeching halt. Unfortunately, when the threat is imaginary, the subconscious mind doesn't realize that there is no real threat. Over time, when this stress response is repetitively triggered by imaginary threats, nature's biological response ends up doing more harm than good.
Long term, if your body is not properly nourished, restored, maintained and repaired, the effects of chronic wear and tear on your body takes its toll and you will end up mentally and physically sick. Therefore, by releasing stress and anxiety, your body creates a loop of positive feedback through the autonomic nervous system, feedback that can rebalance your sympathetic and parasympathetic branches and lead so to significant improvement in symptoms of your stress and anxiety related autoimmune conditions. The degree of improvement you can reasonably expect by relieving your persistent stress and anxiety depends on how much you feel that your emotional state affects your health issues.
When dealing with a fractured bone, the standard medical approach is to align and join the broken parts of the bone and let it heal, as this ancestral approach works for everyone and every time. However, when dealing with stress and anxiety, there is no such thing as a one-size-fits-all approach. Therefore the psychiatry, psychotherapy, hypnotherapy, neuro-linguistic-programming, E.F.T. (emotional freedom tapping), pet therapy, art-therapy, mindfulness, yoga, craniosacral therapy, gravity blanket, mini-horses therapy and many other approaches based on very contradictory and yet scientific concepts, are all available to solve emotional issues.
Chronic, intense or repetitive stress and anxiety can lead to various emotional troubles and even psychiatric or physical medical conditions. According to the American Psychosomatic Society “… there is no such thing as psychosomatic disease. All disease can be looked at from this point of view”.
The following cardiovascular conditions may be aggravated, triggered or even caused by anxiety and stress, or may be conditions for which you may be at increased risk if you are exposed to prolonged or intense stress and anxiety.
How Stress Harms Your Heart: "If someone says their heart is broken, you instantly know what that means: The person is feeling deep grief, usually from the loss of a love relationship or the passing of a loved one. The pain is emotional, but it can feel—and be—physical as well. In fact, cardiac specialists know extreme emotional stress can actually “break” a heart’s functioning by reducing the ability of heart muscles to pump, thereby depriving the brain and organs of oxygen-rich blood. This is called stress cardiomyopathy, also known as “broken heart syndrome,” and cases have been on the rise."
Stress-related disorders linked to heightened risk of cardiovascular disease: “Stress related disorders—conditions triggered by a significant life event or trauma—may be linked to a heightened risk of cardiovascular disease (CVD), finds a large Swedish study published in The BMJ today. The risk of severe and acute CVD events, such as cardiac arrest and heart attack, was particularly high in the first six months after diagnosis of a stress related disorder. "
Stress tied to heart disease, especially in people under 50: "After controlling for physical and mental health history, age, sex, income and other factors, they found that a person with a stress disorder was 29 percent more likely to develop cardiovascular disease than a sibling without a stress disorder, and 37 percent more likely than those in the general population. The risk was even greater in the first year after the diagnosis — 64 percent higher than a sibling, and 71 percent higher than the general population.”
Long-term stress linked to increased risk of heart attack: "Taking stress may be not be good for your heart as a new study suggests that long-term stress may lead to increased risk of heart attack. The study, published in the journal Scientific Reports, indicated that people with higher levels of cortisol are at an increased risk of heart attack"
Stress and anger may exacerbate heart failure: "This study contributes to the extensive literature showing that stress and anger affect clinical outcomes for patients with heart disease, adding chronic heart failure to the list that includes ischemic heart disease (narrowed arteries) and arrhythmic disease."
Mental stress associated with repeat heart attacks: "For some heart attack survivors, mental stress may be a stronger predictor of a repeat heart attack or dying from heart disease, than physical stress, say researchers."
Doctors must address emotions to treat heart problems “It can go dark during despair, feel heavy under stress, beat like a drum when angry, sink like a stone in grief and nearly stop under shock. In fact, sometimes, it does stop due to shock. The heart stops beating and the person dies. This otherwise indefatigable human organ, the most breathtaking clockwork mechanism in the human body, can just as suddenly give up its beat due to grief, stress, loneliness or shock as it would to scaled-up levels of cholesterol, LDL, and triglycerides.”
Uncovering the link between emotional stress and heart disease. "The brain's fear center may trigger inflammation and lead to a heart attack. But stress reduction techniques can break the chain. A small, almond-shaped area deep inside the brain called the amygdala is involved in processing intense emotions, such as anxiety, fear, and stress. Now, a new brain-imaging study reveals how heightened activity in the amygdala may trigger a series of events throughout the body that raises heart attack risk. "This study identifies a mechanism that links stress, artery inflammation, and subsequent risk of a heart attack," says study leader Dr. Ahmed Tawakol, an associate professor of medicine at Harvard Medical School."
Stress and heart diseases: “When we are confronted by a threat, our brain activates the sympathetic nervous system via nerve fibers that originate in certain parts of our brain and connect to the heart. This activation of the nervous system results in the release of stress hormones, which can cause the blood pressure to elevate and the heart rate to rise. Cannon used a term, “voodoo death,” to describe people who literally became “scared to death,” when faced with a very threatening situation, which caused a strong emotional reaction. In those cases, research has shown the brain can release an overwhelming amount of chemicals into our hearts. This “overdose” of brain chemicals can cause heart attacks and other forms of heart damage.”
Mental stress promotes endothelial dysfunction, increases odds of Major Adverse Cardiovascular Events “Transient endothelial dysfunction stemming from mental stress was associated with a 78% increase in the incidence of major adverse cardiovascular events in a study of patients with stable coronary artery disease, providing scientists with a look at just how much psychological stress can influence our risk of cardio vascular diseases.”
Depression and anxiety can spike risk of heart failure : Time and again experts from across the globe have said that there is a Pathophysiological relationship between heart failure and depression and anxiety. According to a latest study by Harvard Review of Psychiatry, about one-third of people who have fallen into traps of depression and anxiety are at higher risk of progressive heart diseases. Christopher Celano, MD, of Massachusetts General Hospital and colleagues were of the view that both anxiety and depression remain under-recognized and untreated in patients suffering from heart failure or cardiac attack. He further said that at times, it becomes challenging for medical practitioners to identify the symptoms of heart failure as there is a significant overlap between psychiatric symptoms and those related to heart failure.
Acute stress induced cardiomyopathy: "Sometimes called 'broken heart syndrome', is a condition triggered by stress and often follows an episode of major stress such as bereavements, involvement in an accident, or divorce – giving rise to its alternative name. Sufferers experience heart attack-like symptoms but investigations reveal that whilst the heart muscle is weakened, there is no blockage in the coronary arteries."
PET/CT shows link between stress and fatal heart condition; "Takotsubo syndrome (TTS), also known as 'stress-induced cardiomyopathy, or as "broken heart" syndrome, manifests as a sudden weakening of the heart muscles that causes the left ventricle to swell at the bottom while the neck stays narrow, according to a statement released by the journal. It is often triggered by severe emotional distress like grief, anger, or fear, or even happiness and joy -- all of which occur in the amygdala, which also regulates the nervous system and heart function – and the condition is more common in women than in men, the journal said. TTS can lead to heart attacks and even death."
Stress, sadness really can break your heart: "Researchers have confirmed in recent years what people long suspected: Extreme stress can literally break your heart. And as they learn more about the relatively rare condition, they are finding that it’s not only caused by the loss of a loved one. Medical treatments, job loss, and other major life stressors have been linked to the condition. The syndrome, known medically as takotsubo cardiomyopathy, mainly affects women. While the medical literature on broken heart syndrome is sparse, more cases are coming to light, with additional information about how it happens and how long-term the risks are."
Stress Can Make Your Heart Pound; “When we're under stress, our hearts beat faster to help blood reach our vital organs. Often it's harmless, but it may not be for those suffering chronic stress. One study from the “European Society of Cardiology” found that people with stressful jobs—nurses or bus drivers, for example—had a 48% higher risk of atrial fibrillation, a condition marked by an irregular, often rapid heartbeat.”
Abnormal Heart Rhythms (Heart Rhythm Disorders) "The key thing to realize is that anxiety can actively cause arrhythmia. But despite that it's not clear why. It's known that a person's heartbeat may speed up during times of stress as a result of the fight or flight system, but an arrhythmia tends to be much more sudden and doesn't always come during times of intense anxiety. Most likely an arrhythmia occurs as a response to sudden and unexpected adrenaline that your body creates when it's stressed. It may also be due to tense muscles or nerve firings that may react to the way you feel mentally. Studies have shown that somehow those with anxiety are more prone to extra muscle contractions of the heart, leading to arrhythmia."
Increased heart rate is often associated with stress and anxiety. "The chemicals released into your bloodstream when you experience stress increase your heart rate, as well as the speed of your breathing (to prepare you for ‘fight or flight’). Some people notice this change in heart rate more than others and interpret it as dangerous (e.g. “I am having a heart attack”) This is distressing and leads to the heart rate increasing further with increased distressing thoughts and a sense of panic. Such episodes, usually around 10 to 15 minutes in length are known as panic attacks. You might feel shortness of breath, breath quickly and have a sense that you can’t breathe properly. This is called hyperventilation is very common in anxiety.”
Stress Can Raise Your Blood Pressure; “Stress gets your heart pumping faster and spikes your blood pressure. Not good. Usually, the response is temporary, a reaction to a particular stressful event. But chronic stress over long periods of time can cause inflammation in the arteries, which could lead to a heart attack down the road.”
High Blood Pressure "Chronic emotional and mental stress is a big contributor to high blood pressure. That's because stress causes a sustained increase in the activity in the sympathetic nervous system—the part of your nervous system associated with the fight-or-flight response. When your sympathetic nervous system is activated, it floods your blood with cortisol and adrenaline, accelerating your heart rate, constricting your blood vessels and increasing blood pressure."
Heart Attack "Psychological stress is also recognized as a possible cause of acute coronary syndrome (ACS), a collection of symptoms that indicate a heart attack or approaching heart attack. High levels of psychological stress are associated with harmful changes to the blood. Research suggests that stress has the potential to trigger ACS, particularly in patients with heart disease. Studies also suggest that the risk is greatest immediately after the stressful incident, rather than during it ."
Heart attack and stroke: "The hormones cortisol and adrenaline are released in to the blood stream by the adrenaline gland when a person experiences a stress response. Adrenaline increases the heartbeat and blood pressure and in the long term can cause hypertension, while long term release of cortisol in the blood can lead to cholesterol plaque build-up in the arteries. Both of these issues can lead to an increased chance of a heart attack or stroke."
Here’s How Stress Might Cause Heart Attacks, Strokes "Our results provide a unique insight into how stress may lead to cardiovascular disease," Dr. Ahmed Tawakol of Massachusetts General Hospital and Harvard Medical School, who led the study team, said in a statement. "Eventually, chronic stress could be treated as an important risk factor for cardiovascular disease."
High stress activity in the brain may indicate a future risk of heart attack and stroke, according to new research. Ahmed Tawakol of Massachusetts General Hospital coauthored the recent study, which found that those with a higher level of activity in the stress center of the brain showed evidence of arterial inflammation—a leading cause of many cardiovascular events such as heart attacks and strokes. According to Tawakol, high levels of stress in the brain have been found to be as pertinent as smoking, high cholesterol, and high blood pressure in causing heart disease. In order to promote cardiovascular health, it is necessary to find ways to reduce stress in your life.
Stress in younger women linked to higher rate of heart issues: Now, a new study published in the Journal of the American Heart Association finds that young women with mental or emotional stress have a higher rate of reduced blood flow to the heart—this can result in heart attack and other cardiac complications. Researchers found that stress reduced blood flow happened much more commonly in younger women as compared to older women and men. In fact, the frequency of reduced blood flow almost doubled in women compared to men for every 10-year decrease in age. Ultimately, these findings suggest that women with heart disease in their 30s, 40s and early 50s are more vulnerable to the damaging effects of psychological stress on their heart.
Stress and heart health: “New data sheds light on the mechanism behind stress and heart health. It’s clear that there’s a link between stress and heart health; what’s not clear yet is why the two are connected. Now, a new study suggests that people with higher levels of stress also have more inflammation in their arteries, putting them at higher risk for heart problems. In the new study, presented at the American College of Cardiology’s 65th Annual Scientific Session, researchers used imaging to look at 293 people’s brains and arteries. They found that stress activity in an area of the brain called the amygdala, which is where emotions are processed, was linked to more inflammation in a person’s arteries. This is notable because arterial inflammation is an important driver of atherosclerotic disease, the major cause of heart attacks and stroke.”
Stress identified as cause of heart disease: "It’s become clear that stress is not only a result of adversity but may itself also be an important cause of disease. The risks of heart disease linked to stress are on par with that for smoking, high blood pressure, high cholesterol and diabetes, yet relatively little is done to address this risk compared to other risk factors"
Effective stress management helps the heart: "Long-term or chronic stress can have a negative impact on the heart and the entire cardiovascular system. The specific results of chronic stress have been identified as contributors to heart disease, high blood pressure, increased cholesterol rates and other factors dangerous to the heart."
What you need to know about stress and varicose veins: “When we become stressed, our blood pressure rises. When blood pressure remains elevated, either consistently or chronically, our blood vessels weaken. This inhibits circulation, causing blood to pool in the veins. This pooling can result in varicose veins.”
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