The beat
of the heart

By AMY NEFF ROTH
Healthy Living

Stress is bad for the heart.
Why? How bad? All kinds of stress?

Researchers are still tackling those questions. No one knows whether stress directly causes heart disease.

Utica cardiologist Dr. Fred Talarico can tell you that, at the very least, stress raises your blood pressure, raises your heart rate, interferes with sleep and hurts the immune system. None of that is good for the heart, he said.

Higher blood pressure makes the heart walls thicker and causes plaques to develop in the arteries, Talarico said. And a higher heart rate forces the heart muscle to work harder, he said.

Yet stress, he said, is all around us.
“There’s so many things we do in our lives that seem to promote stress. We eat on the run ... In other parts of the world, people work to live. We live to work. We are constantly on the go,” Talarico said.
That’s not to say that all stress is bad. “Our heart’s supposed to react to situations that are fearful,” he said. The problem comes when the situation becomes almost permanent, Talarico added.

Dr. Diwakar Jain, a researcher studying heart disease and stress, agreed.
“Stress by itself is not detrimental ... Stress is a big motivator for people to perform better. After all, it is the fear of losing a job which gets people up in the morning even if they don’t feel like getting up,” said Jain, a professor and director of nuclear medicine at Drexel University College of Medicine in Philadelphia and co-author of “The Emotional Wellness Way to Cardiac Health: How Letting Go of Depression, Anxiety and Anger Can Heal Your Heart.”
But when fear and stress run out of control, that’s when problems begin, he said. Through his own research, Jain knows that stress expressed as anger, hostility and depression do aggravate existing heart disease.
Here’s what his research has found, according to Jain:

To study stress, it must be simulated in a lab. One way is to ask subjects to describe an episode that made them angry and them probe further. Another method is to ask people to do mental arithmetic, for example by asking them to subtract one number from another and to keep going.
ä Under these circumstances, some patients who already have heart disease show a reduction of blood flow to the heart muscle, reducing the squeezing power of the heart and making the patients more prone to arrhythmias. The patients most likely to suffer these problems are the ones who scored high on anger, hostility and type A personality behaviors.

Following these patients over one or two years, they were more likely to die, have another heart attack or develop a life-threatening arrhythmia.

A lot of research now, including his own, is focused on figuring out whether cognitive behavioral therapy can relieve stress and decrease damage to the heart.
“Stresses in life, they cannot be altered,” Jain said. “Life is what it is. There are happy situations, unhappy situations. What can be altered is the way individuals respond to those situations, that instead of responding in a hostile or angry manner, they can respond in a calm or neutral manner.”
So, if certain kinds of stress make heart disease worse, are they also bad for healthy hearts?
“That is a $1 million question,” Jain said.
The research, so far, has yielded mixed results, he said. There is some evidence that stress does make certain risk factors worse, as Talarico suggested, Jain said. And people who are depressed or angry may be less likely to take proper care of themselves and more likely to smoke, he said.
The bottom line is that whatever researchers have or haven’t proven about heart disease, the best strategy is to find ways to reduce the stress in your life, Jain said.
“Despite all the caveats and despite all this missing data, it is pretty clear that stress and certain adverse behavioral factors ..., they’re not good for the heart,” he said.
“And a combination of them, that somebody is angry and hostile or maybe depressed and ends up working in a stressful environment, is detrimental to the cardiovascular health of the individual.”