Do you feel stressed out and overwhelmed?

Most Americans would likely answer yes according to an annual Gallop Poll survey this year. It shows Americans report feeling anger, stress and worry at the highest levels in 10 years.

Everyone handles stress differently and doctors say managing it is important for your health. Too much stress for too long can be very bad for your heart and can lead to an elevated risk of high blood pressure, heart disease, chest pain and even irregular heartbeat.

Why does stress affect our heart?

“The way our body works is we have the ability to respond to stressful situations,” said Dr. J. Travis Wilson, an Allegheny Health Network cardiologist with offices at Canonsburg General Hospital. “That is, on many levels, a physiologic response and that has to do with various stress hormones in your body. These are different from what you typically think of as hormones. They work on different pathways in your body that helps you mount a response to stress.”

The classic response Wilson mentioned was the “fight or flight” reaction which prompts the human body to respond to a stressful situation by either fleeing or defending itself.

That means the body release the hormone adrenaline which temporarily raises our heart and breathing rates and boosts the blood pressure.

Wilson said there is a downside.

“Some of these hormones that physiologically help you do that can overwhelm the heart,” he said. “There is something called stress induced cardiomyopathy where the heart muscle actually becomes weakened. The heart is literally just overwhelmed with these stress hormones and they weaken the heart.”

Patients normally recover, Wilson noted, but it is one of the few conditions that truly can be acute.

“You can go from having a normal, healthy heart,” he said, “and five minutes later, your heart muscle is very weak.”

This phenomenon can happen when someone is going through an extraordinarily stressful period of their life or experiences an extremely emotional situation such as the sudden loss of a loved one.

“They’re overwhelmed with grief and that translates into an overwhelming physiologic response to an emotional stress,” Wilson said. “The most common used term is Broken Heart Centered Stress Disorder. It’s also called broken heart syndrome.”

Those situations represent an extreme reaction to acute stress. But the body’s reaction to everyday, recurring stressful situations long-term can also harm the heart and overall health.

Wilson said physicians are increasingly realizing the role stress can play in various conditions and particularly with the heart. It can lead to extra heartbeats and an irregular heartbeat.

“I think it’s a fair statement that the more stress we have in our lives or if we don’t deal with stress in a healthy way, it affects our sleep,” Wilson said. “With respect to cardiovascular health, poor sleep habits lead to an increased risk of heart disease. So that’s one indirect relationship there.”

Another factor is the way in which people deal with stress. Stress can lead to overeating or poor eating habits and that can affect our diet, nutrition and weight which can also be a factor in developing heart disease.

“So it’s not necessarily just stress that physically affects our heart directly, except for maybe the heartbeat,” Wilson said. “But it affects our lifestyle and affects the way we behave and all of those can have negative implications on our cardiovascular health.”

Another aspect of stress and heart health deals with hardening of the arteries and blockages.

Wilson said research shows a direct relationship between the two and the more stress a person is under, the more likely they are to have a cardiac event.

“That gets back to the idea of the arrhythmia issue where I don’t know that stress causes arrhythmia, but it can exacerbate some if you have the underlying substrate,” he said. “In other words, stress doesn’t cause a condition such as atrial fibrillation on its own, but it can exacerbate it or cause the symptoms to appear if you have the underlying condition. The same logic applies to hardening of the arteries.

“I don’t know that stress leads to the buildup of atherosclerotic disease directly,” he added, “but it definitely can exacerbate symptoms of it.”

It may be impossible to eliminate all stress in our lives, so what steps can be made to protect the heart from the effects of stress?

The biggest challenge is to manage stress in a healthy way. One of the best methods to do this is through exercise.

“Obviously, that has positive implications for your cardiovascular health,” Wilson said. “Adopt a healthy diet, regular exercise… that can lead to healthy habits with respect to handling stress and reducing stress.”

Another coping mechanism is to try to avoid the triggers that may induce stress.

“That’s obviously easier said than done,” Wilson said, “and to try to avoid those unhealthy strategies for handling stress such as stress eating and things of that nature. Always try to keep your cardiovascular health at the center of your approach to stress.”


Kristin Emery is a meteorologist at KDKA-TV in Pittsburgh, an O-R columnist, and writer for Total Health magazine and other publications. Kristin is a Washington native and a graduate of Washington High School and West Virginia University.

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