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In this article:
Key Points
- Stress is an inevitable part of life, and by finding ways to cope, you'll be doing your heart a favor.
- Stress breeds irritability, anxiety and depression, and it can prompt physical symptoms such as headaches and upset stomach.
- Stress makes the heart work harder, which can worsen angina pain.
- For patients with heart disease, stress management might be as beneficial as aerobic exercise to help prevent further heart troubles.
Stress is an inevitable part of life: the car breaks down, a family argument erupts, a job deadline looms, and this year's tax bill is heftier than the bank account.
If you're also coping with a chronic and sometimes painful condition such as angina, your stress level may be even higher. Find ways to cope with stress better, and you'll be doing your heart a favor.
Why? Because stress does more harm than causing irritability, anxiety, and even depression. Scientists have long known that emotional stress can also bring on physical symptoms such as headache, upset stomach, or insomnia.1
The heart works harder when it's stressed
Anxiety and stress make your heart work harder, which can worsen angina pain. Stress causes your brain to signal the adrenal glands to release a hormone that triggers the body's "fight-or-flight" response. Blood pressure and heart rate then rise, which increases the heart's workload. The heart needs more oxygen, but the arteries that have been narrowed by coronary artery disease can't deliver enough oxygen-rich blood to the heart to meet the demand. So the risk of an angina attack goes up.
In contrast, reducing stress may benefit the heart. Pursuing a calm, quiet, relaxed state can lower heart and breathing rates—an antidote to the "fight-or-flight" response. Finding productive ways to cope with stress can also prevent unhealthy habits—such as smoking or junk-food binges—that can promote or worsen heart disease.
What's more, research published in the American Heart Association's journal Circulation suggests that besides stress and anxiety, anger may also harm the heart.2 A study of 12,986 African-American and white men and women showed that people who rated high in traits such as anger but had normal blood pressure were more prone to coronary artery disease or heart attack. The scientists found that people who were angriest had roughly double the risk of coronary artery disease and almost three times the risk of heart attack compared with people who had the lowest levels of anger.
The scientists aren't sure exactly how anger increases risk. But they suspect that angry emotions trigger a variety of physiological changes that damage the heart and vessels, and, in some cases, can even trigger fatty plaque ruptures and heart attacks.
High blood pressure is a heart disease risk factor by itself, and other studies have suggested that a strong, angry temperament may place middle-aged people with normal blood pressure at a similar level of risk for heart disease as people with hypertension. As evidence mounts suggesting that stress, anxiety and anger may be damaging, it pays to find ways to stay calm and relaxed.
Ways to reduce stress
Sometimes, a warm bath, relaxing music, or a massage can work wonders to relieve stress. So can exercising or having a long talk with a supportive friend. If you or someone you love has angina, consider the following stress-reducing ideas as well.
- Counseling.
Some studies have linked hostility, depression, stress, and social isolation to heart disease. For some, professional counseling can provide a better perspective on personal conflicts. Counselors can teach new behaviors to replace unproductive ways of reacting to stressors such as anger. Some also teach stress-reduction methods such as progressive relaxation, breathing techniques, meditation, and guided imagery.
For patients with heart disease, stress management might be as beneficial as aerobic exercise to help prevent further heart troubles, a new study in the American Journal of Cardiology suggests.3 Duke University Medical Center researchers divided 94 patients with heart disease into three groups: one group did aerobic exercise, the second group took stress-management classes, and the control group received standard care.
Researchers monitored these patients for five years. The group receiving standard care turned out to have the most cardiac events, such as heart attacks, open-heart surgery, and angioplasty. But the group that studied stress management had fewer problems—equal to that of the aerobics group.
If you're interested in stress management, ask your doctor, hospital social worker, or religious leader for a referral to a counselor.
- Spiritual practice. Many people discover that prayer or meditation increases their sense of calm and inner peace, helps them deal with fears and frustrations, and provides them with greater strength to cope with life's problems, big and small.
Whether spirituality helps improve mental and physical health is a topic that interests researchers.4 Spiritual practice may even change health habits for the better by helping people avoid smoking, excessive drinking, and drug abuse.
Meditation, a practice once considered beyond the mainstream, is now embraced by some hospitals; such institutions offer meditation classes, combined with conventional treatments, to help improve patients' quality of life.
- T'ai-chi. Exercise is a potent way of releasing stress.
T'ai-chi (pronounced "tie-CHEE"), a slow, gentle Chinese form
of exercise, is especially helpful for patients who cannot, for
physical or other reasons, do more energetic activities. T'ai-chi
movements are flowing and continuous, and place little stress
on muscles and joints. Some people who do t'ai chi regularly say
it calms them, helps them to cope with stress, and fosters a greater
sense of well-being.
- Yoga. Practitioners of this ancient Indian discipline
of prescribed postures, breathing, and meditation techniques say
that yoga helps people learn to relax physically and mentally.
They can also learn to better manage their reactions to stress.
Yoga was also part of Dr. Dean Ornish's Lifestyle Heart Trial in
1998. Twenty-eight patients with heart disease modified their lifestyles through
an intensive program of a low-fat diet, exercise, group therapy, meditation,
and yoga. After one year, most of these patients had less artery
plaque,
as well as less trouble with angina pain.5
- Biofeedback. With this type of treatment, tense or anxious patients learn to relax by using signals from their own bodies. Under the supervision of a biofeedback therapist, a patient is hooked up to an electronic biofeedback machine that records biological functions (such as heart rate or muscle tension), helping him or her to learn how to control these processes. For example, one type of machine detects electrical signals in the muscles and then translates these signals to the patient in the form of a flashing light or a beeper that goes off every time muscles tense up. The patient attempts to slow the flashing or beeping by relaxing the muscles. The biofeedback therapist gives advice on how to improve control. After training, the patient may be able to repeat this relaxation response at will, without the help of a machine.
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Breast cancer and HIV/AIDS cause more deaths in the United States than heart disease. True or False?
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Sources
1. The Mayo Clinic Family
Health Book. New York: William Morrow & Co., 1996. 309.
2. Williams, J.E., Paton, C.C., et al. "Anger Proneness Predicts Coronary Heart Disease Risk." Circulation.
2000 May 2;101(17):2034-9.
PubMed
3. Blumenthal, J, M. Babyak,
et al. "Usefulness of psychosocial treatment of mental stress-induced
myocardial ischemia in men." American Journal of Cardiology,
2002, Vol. 89. 164-168.
PubMed
4. Brody, Jane and Denise Grady,
The New York Times Guide to Alternative Health. New York:
New York Times Co., 2001. 203-244.
5. Ornish, D., Scherwitz, L.W.,
et al. "Intensive Lifestyle Changes for Reversal of Coronary Heart
Disease." Journal of the American Medical Association (JAMA),
1998, Vol. 280. 2001-2007.
PubMed
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