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Stress-related cardiovascular diseases

    Stress and anxiety do not only affect daily life, they can also have a profound impact on health, particularly on the 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, there is no laboratory test 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. Since 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 immobilize the bone and let it heal, because this ancestral approach works on all bones. 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, 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.

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.”

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.”

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.

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"

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Disclaimer: The above content is intended for general informational purposes and does not constitute any psychological or other medical professional advice. I don't diagnose conditions, nor do I interfere with any treatments given by your medical professional.

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