How Might Stress Cause Heart Disease?

17 Jan


In 1959, a cardiologist named Meyer Friedman began publishing an influential series of studies suggesting people with certain personality traits have a higher risk of developing heart disease. Individuals with what he called a Type A personality were especially preoccupied with time. Type A’s displayed a perpetual compulsion to quickly achieve as much as possible and became exasperated with obstacles to their goals.  In a 1959 study published in the Journal of the American Medical Association, Friedman found the prevalence of coronary artery disease was significantly higher in men with Type A personalities than in their otherwise similar peers.  Soon Type A became a popular term in everyday speech.


Physicians before Friedman also recognized the connection between the mind and heart. William Harvey, who is credited with discovering the circulatory system, wrote in 1628 that “every affection of the mind that is attended with pain or pleasure, hope or fear, is the cause of agitation whose influence extends to the heart.” And William Osler, who is considered the father of American medicine described the typical individual who develops coronary artery disease as a “keen and ambitious man, the indicator of whose engines are set a ‘full speed ahead.’ “


This month the medical journal The Lancet published research suggesting how emotional stress might cause cardiovascular disease. The study used brain imaging to measure activity in a part of the brain called the amygdala.  The amygdala is thought to be responsible for triggering the “fight or flight” response when we encounter danger.  Researchers found that higher activity in the amygdala was associated with increased activity in the bone marrow, inflammation in arteries, and bad cardiovascular outcomes such as heart attacks. The study’s authors hypothesize that stress activates the amygdala, which tells the bone marrow to produce cells that cause inflammation in arteries, which in turn raises the risk for heart attacks and strokes.


In a discussion of the study, its authors suggest that clinicians “could reasonably consider the possibility that alleviation of stress might result in benefits to the cardiovascular system” and that “eventually, chronic stress could be treated as an important risk factor for cardiovascular disease.”  Here are some common sense strategies for managing stress.


Get enough sleep: There is abundant evidence that sleep enables people to function at a higher level and better cope with stress. Overwhelming problems sometimes become manageable after a good night’s sleep.

Exercise: Exercise increases chemicals called endorphins that reduce pain and trigger positive feelings. It also improves sleep and lowers blood pressure.

Connect with people: Cultivating a strong network of family, friends, and colleagues will provide people to turn to when you need help. When problems happen, others can provide perspective, solutions, and encouragement.

Help other people: Caring for people in worse situations than yours can put your problems into perspective and promote gratitude for what you have. Knowing you’ve made a positive impact in somebody else’s life can also increase self-esteem.

Keep a gratitude journal: At the end of each day, write down what you are grateful for.

Avoid overcommitting: Having more obligations than you are capable of fulfilling predictably leads to feeling overwhelmed. Before committing to something, make sure you have the time, energy, and motivation to follow through. If you are already overcommitted, consider what commitments you might end.

Take breaks: Reflect upon what activities make you happy and recharged. Regularly make time to do them.

Meditate: According to the NIH’s National Center for Complementary and Integrative Health “some research suggests practicing meditation may lower blood pressure, symptoms of irritable bowel syndrome, anxiety, depression, and insomnia.” During meditation, you focus your attention and set aside the stream of jumbled thoughts that may be causing stress. One simple form of meditation is focusing on your breath as you inhale and exhale. As thoughts inevitably enter your consciousness, gently turn your attention back to your breath. Here is link to a website with instruction on how to meditate.


You can read the abstract to The Lancet study on stress and heart disease here.


Posted by on January 17, 2017 in Uncategorized


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