Dear Doctor K: I’m under a lot of stress in my life. Of course, I don’t like that, but what really worries me is that it will affect my heart. Heart disease runs in my family. If stress can lead to heart disease, does reducing stress reduce heart disease risk?
Dear reader: We often think of the heart and brain as separate from each other, yet these organs are intimately connected. And when your emotions adversely affect your brain, your heart is affected as well.
There are two kinds of stress that impact your brain. Helpful stress can assist you with getting things done by helping you focus your attention. Unhelpful stress (distress), on the other hand, can be so severe that it can lead to fatigue and heart disease.
Coronary artery disease (CAD) restricts the flow of oxygen-rich blood to your heart. Emotional stress can worsen oxygen deprivation. In fact, if you have heart disease, any strong emotion, such as anger or grief, may cause severe and fatal irregular heart rhythms.
How do strong emotions affect heart disease? In two ways. First, they cause the heart to beat faster and more forcefully – to work harder. Second, they increase the tendency of the heart arteries to narrow, reducing the blood supply to the heart. So the heart is working harder, but without the blood supply it needs. That can cause dangerous heart rhythms.
Depression also increases the risk of heart problems, including heart attacks and dangerous heart rhythms. If chronic stress has made you depressed, then the stress is threatening your heart in a third way.
The good news is that the opposite is also true: Reducing your level of stress lessens the risk to your heart. Here are some ways to start reducing your stress:
SEEK PROFESSIONAL HELP. Don’t ignore stress, anxiety, depression, excessive worry or bouts of anger that overwhelm your life. Anger is particularly dangerous for the heart. Treatment can help reduce symptoms. This will help protect your brain and your heart.
PURSUE TREATMENTS IN CARDIAC PSYCHOLOGY. This employs psycho-educational programs, educational training, stress management, biofeedback, counseling sessions and relaxation techniques before or after a heart-related event. These programs are done in addition to, not instead of, traditional psychiatric treatment and exercise.
EXERCISE. Physical exercise can help you have a healthier heart and brain. Various types of aerobic exercise have proven to reduce anxiety and depression and to improve self-esteem. Jogging, swimming, cycling, walking, gardening and dancing are good options.
If you struggle with stress, anger, anxiety, worry, depression or problems with self-esteem, talk to your primary care physician. If your stress is severe, and your risk of heart trouble is high, you may need a consultation with a cardiologist, a psychiatrist or a stress reduction program. Together, you can explore which therapies might best protect your psychological state, your brain and your heart.
Dr. Komaroff is a physician and professor at Harvard Medical School.
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