The typical image of someone who, under extreme stress, ends up suffering from all kinds of medical conditions, such as hair loss, gastrointestinal problems and also a heart attack, is very well established in the popular collective.
Although the relationship between stressful situations and heart problems has always been taken for granted, it is only relatively recently that stress has been incorporated as a risk factor for heart disease.
In this article we will see how stress affects the heart , explaining the importance of the evolutionary phases of a stressful response as well as commenting on some strategies to achieve a healthier heart.
How does stress affect the heart?
Stress is an emotion that is present throughout the world at some point in their lives. Like any emotion, it involves a number of consequences depending on its degree of occurrence, intensity and type.
One of the most popular definitions of stress is that it is a fight or flight reaction to a threatening situation, although this is not entirely correct. Nowadays, we understand stress as that physiological, psychological and behavioural response that a subject carries out to adjust and adapt to pressures , both internal and external, to which he has been subjected.
These pressures can be truly threatening and involve a negative response in both the individual’s mind and body (distress). However, stress can also appear in a beneficial context for health, such as the performance of a high-intensity sport (eustrus).
As already mentioned, stress implies a physiological response, which can be observed by looking at the hormonal changes that the individual presents . The organism is put on guard and prepared to face a situation that it must overcome to guarantee its survival. A whole series of changes occur at a circulatory level. Levels of glucose, red blood cells, leukocytes and platelets in the bloodstream are raised.
The body focuses its energies on the brain, the heart and the muscles, to the detriment of the rest of the organs. The heart rate increases, the muscles contract increasing for a short period of time the strength of the individual, breathing accelerates, the coronary vessels and also the skeletal muscles dilate while the vessels related to the digestive system contract. The bladder relaxes, the rectum contracts, the pupils dilate, and the body begins to sweat.
Although stress has been associated with heart problems since time immemorial, it is only relatively recently that stress has been included as a factor in the development of cardiovascular disease. Cardiopsychology is the branch of health sciences that defines the relationship between psychosocial factors and the onset and rehabilitation of heart disease.
People who are more susceptible to this emotion are also more likely to have cardiovascular problems, such as cerebral ischemia or stroke, angina pectoris and heart attack .
The blood pressure shoots up and malignant arrhythmias occur. There is a greater risk of thrombosis, as platelets in the blood increase and clotting increases. In turn, insulin efficiency decreases and levels of low-density lipoproteins, popularly known as good cholesterol, also drop. The blood becomes thicker and the arteries lose elasticity, accumulating harmful substances in their walls and making it difficult for the blood to pass through.
The sympathetic nervous system, if kept active for a long time, starts to work inefficiently . This causes problems with the electrical conduction to the heart, contributing to the irregular heartbeat (arrhythmia). In the most serious cases, the arrhythmia may turn into a sudden stop of the heart, which would cause the death of the individual.
Importance of the phases of stress
As mentioned, not all stress is bad. On the contrary, it is a response that guarantees the survival of the individual if it is given in the right situation and at levels that imply high functioning for the individual.
The problem comes when the organism manifests this response for too long or with too high an intensity to a threat that, perhaps, is not so bad.
That is why, in order to understand a little more thoroughly the difference between healthy stress and distress, we present the phases of this process, relating them to cardiovascular health.
1. First phase: alarm
The alarm is the first phase of response to a stressful event. It is here that the individual decides to opt for one of the following two strategies: fight or flight.
This phase involves high energy consumption and is key for the individual to adapt to the new situation.
If the alarm phase is adequately overcome, it automatically moves to the recovery phase, inhibiting the sympathetic nervous system and predominating the parasympathetic, which restores the balance prior to the appearance of the stressful stimulus.
2. Second phase: resistance
If the first phase has not been successfully passed and recovery has not occurred, the resistance phase is entered.
The individual remains active and focuses his or her forces to cope with the threatening situation, which causes energy reserves to be progressively depleted. On the other hand, the neuroendocrine system is subject to intense activity , making it ineffective until it fails.
The reasons why stress manifests itself ineffectively may be related to being exposed to an acute very intense or chronic stressor.
It may also be due to the individual himself, who has a personality disorder, does not have efficient resources to cope with stress or has an organic disease that influences the neuroendocrine system.
3. Third phase: exhaustion
At this point, when the organism has been subjected to a lot of pressure, stress becomes a health problem , contributing to the appearance of both physical and psychological pathology.
How to prevent the effects of stress on the heart?
One of the fundamental factors for having a good quality of life is having low levels of stress, as well as having the necessary resources to know how to deal with situations that imply some change or are threatening in a healthy way. Below are some strategies that can help reduce the harmful effects of stress on cardiovascular health.
1. Physical exercise
Sedentary people are more prone to heart problems. This is not only because not exercising frequently means health problems already, but also because people who do not exercise often tend to feel more moody and irritable.
Thus, their cardiovascular risk is twofold, since they can develop medical conditions such as obesity, high blood pressure or hypercholesterolemia, involving increased pressure on the heart.
It is advisable to perform exercises that involve large muscle groups for long periods of time, such as swimming, cycling or aerobics.
Another key to good cardiovascular health is to control what you eat.
A balanced diet with appropriate amounts of carbohydrates, healthy fats, proteins, trace elements and vitamins, promotes the proper functioning of the cardiovascular system, in addition to providing good emotional stability.
Fats and sugars can contribute to being in a bad mood , and therefore tend to be stressed. Foods containing these nutrients should be eaten in moderation. Caffeinated beverages, especially colas and coffee, should also be reduced, as well as alcoholic beverages and tobacco, as their components increase the occurrence of stress.
It should be noted that not all caffeinated beverages are potentially stressful, as green tea promotes the positive regulation of stress hormones.
3. Sleep well
Those who sleep badly are in a bad mood the next day and, of course, are more likely to ‘attack’ at the slightest thing. You should try to get at least seven hours of sleep a day, since sleep helps renew cells.
Not sleeping can cause the individual to be immersed in a cycle that feeds back , as they become more and more stressed and, in turn, the stress causes insomnia.
Techniques such as pilates, yoga, tai chi or simple controlled breathing can be of great benefit in reducing stress, calming not only the mind but also the heart.
With this type of technique the heart rate is reduced , decreasing the risk of suffering heart problems such as heart attacks or irregular heartbeat. Blood pressure is lowered, circulation is improved, and the immune system is boosted.
5. Professional help
If you have serious problems managing stress and are already showing symptoms of possible heart problems, seeking professional help never hurts.
The doctor will make sure whether there is a risk of suffering from a heart disease or not, while going to the psychologist will help to acquire strategies to adequately deal with situations that cause stress.
In case of too high stress due to the person being very irascible, it is highly recommended to attend anger management courses.
- Alonso-Fernández, C. (2009). Stress in cardiovascular diseases. In López-Farré, A. and Macaya-Miguel, C. Libro de la salud cardiovascular del Hospital Clínico San Carlos y la Fundación BBVA. (583-590). Spain: BBVA Foundation.
- Cohen B. E., Edmondson D., Kronish I. M. (2015). State of the art review: depression, stress, anxiety, and cardiovascular disease. Am J Hypertens. 2015;28(11):1295-1302.
- Wei J., Rooks C., Ramadan R., et al (2014). Meta-analysis of mental stress-induced myocardial ischemia and subsequent cardiac events in patients with coronary artery disease. Am J Cardiol.114(2):187-192.
- Williams, R. B. (2015). Anger and mental stress-induced myocardial ischemia: mechanisms and clinical implications. Am Heart J;169(1):4-5.