Stress and heart disease

Neglecting your mental health can raise your heart disease risk

You eat oily fish, you walk daily, you quit smoking years ago, and you go easy on saturated fats. So, it’s fair to say your heart is in great shape, right? Not necessarily.

Recent research from Emory University suggests that harboring negative feelings — such as anger, guilt and hostility — or disregarding mental health issues like depression and anxiety — can put you at high risk of coronary heart disease and stroke.

The study — of a large mixed sex sample in the United States — showed that negative emotions and mood states caused elevated levels of C-reactive proteins, which are associated with inflammation in the body and cardiovascular disease. And, surprisingly, the effects were independent of risk factors such as smoking and being very overweight. In other words, even if you think you are doing ‘all the right things’, if you are neglecting your mental health then you are potentially still exposing yourself to a significant risk factor.

This isn’t the first study to indicate a link between mental and physical health, of course. Finnish researchers in 2002 reported that people with stressful jobs could be twice as likely to die from heart problems, while a study at Duke University showed that the stress of performing difficult number problems could constrict the coronary arteries enough to reduce blood flow to the heart. Another way that mental discontent can have a negative impact on our physical health is that it often leads us to unhealthy coping strategies, like smoking, excessive drinking or overeating.

But what’s the solution? Do we all need to sign up for lifelong therapy to reduce our risk of heart disease? Well, there are two ways of looking at it.

The first option is to reduce or eliminate the causes of stress, anger, guilt, hostility … whatever — from your life. That’s doable if it’s a faulty starter motor that is sending your blood pressure soaring every morning — get it fixed. But what if it’s something less easy to change? Your husband, for example! While several studies have documented that people without spouses die earlier than married people — demonstrating the importance of close, loving relationships — some fascinating new research, this time from Ohio State University, found that stress caused by one’s spouse, in the form of a 30-minute row, impeded the healing of a laboratory-induced blister. So the old saying, ‘never sleep on an argument’ holds true …

The other option, then, is to change the way you react to situations that cause you to feel negative. But while some would argue that making diet and lifestyle changes to enhance health is a tough call, at least eating more fruit and veg, or cutting down on red meat, are easily definable challenges. Reducing stress, or letting go of anger or guilt, on the other hand, first require you to identify the feeling and its root cause.

‘As with all lifestyle changes aimed at reducing heart disease risk, such as stopping smoking or reducing weight, behavioural changes are not easy to achieve — nor do they happen quickly,’ points out Dr Ed Suarez, one of the Emory study authors. ‘The first step towards change is to notice what events individuals respond to with the negative emotion in question. For example, people should ask themselves — ‘when do I get angry? When do I get depressed? Is it when I deal with people at work? Talking to my relatives? Do my kids make me angry all the time?’ Then, says Dr Suarez, when you have identified these situations, you have to come up with alternative responses, and then practice applying them. ‘For example, if you know you have a meeting at work and that situation gets you angry, you need to give yourself a cue not to get mad,’ says Dr Suarez. ‘One easy way is to remove your wedding ring and place it on the other hand. It will feel ‘funny’ on the other hand, providing a physical reminder that you are trying to change your behavior and aren’t going to get angry.’

The Emory University study found that post-menopausal women were most at risk from mental health-related risk factors, but research from Texas Tech University found that a stress reduction program significantly reduced anxiety in women with existing heart disease. So whether its meditation, yoga, journal writing or divorce(!) — find something that helps you unburden yourself of daily worries and anxiety. ‘Attaining and sustaining good mental health is just as vital as other factors, such as exercise and diet, in the prevention of cardiovascular disease,’ concludes Dr Suarez.

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