Do you think you're stressed? What it might be doing to your heart
In a first analysis, researchers find a link between coronary heart disease and perceived stress. The study is novel because the authors say it applies to almost everyone. The finding showed that people who appraise themselves as having high stress had a 27% higher chance of coronary heart disease (CHD).
The finding comes from researchers at Columbia University Medical Center investigators and is published in a recent issue of the American Journal of Cardiology.
For the study, senior author Donald Edmondson, PhD, assistant professor of behavioral medicine at CUMC and his colleagues looked at studies that asked people if they felt stressed and how often.
The participants were followed for 14 years to track the number of heart attacks and compare between two groups separated into high and low stress scores.
Edmondson said in a press release, “This is the most precise estimate of that relationship, and it gives credence to the widely held belief that general stress is related to heart health.
In comparison with traditional cardiovascular risk factors, high stress provides a moderate increase in the risk of CHD – e.g., the equivalent of a 50 mg/dL increase in LDL cholesterol, a 2.7/1.4 mmHg increase in blood pressure or smoking five more cigarettes per day.”
LDL cholesterol is considered a risk for heart disease that can lead to heart attack because it contributes for narrowing of the arteries that supply blood flow to the heart from plaque buildup, or atherosclerosis.
Higher blood pressure puts stress on the heart and contributes to stiffening of the arteries, making them more susceptible to blockage.
According to the authors, 385,000 people die each year from CHD in the United States alone.
When the researchers looked at what might underlie stress, they found age was the most important factor. The link between heart disease and stress was stronger among older people.
The researchers say it may be that stress compounds over time. Being stressed in your 40’s and 50’s might put you at higher risk for heart attack and other cardiovascular events later in life. The combination of stress and other factors like high blood pressure that become more common with aging may be what’s contributing to the higher rates of heart disease found in the study.
Edmondson suggests more studies to find out if stress reduction interventions would be a cost effective way to help lower the incidence of CHD.
Further research should look at whether the stress that people report is about actual life circumstances or just related to type A and type B personality types, Edmonson said. He also suggests more understanding is needed about the biological reasons stress leads to higher risk of coronary heart disease.
Researchers know acute stress raises the risk of heart attack, even years later. The current study is the first to show perceived stress raises heart disease risk.
The perceived stress scale is a widely used tool and asks questions like, “In the last month, how often have you been upset because of something that happened unexpectedly?; In the last month, how often have you felt that you were unable to control the important things in your life?; In the last month, how often have you felt nervous and “stressed? Answers are submitted using a scale of 0 to 4 and includes ten questions. Zero indicates ‘never’ and 4 is ‘very often’. High stress groups have an average score of 20.
Ways to reduce stress include taking charge of your health – smoking cessation, weight loss, exercise and dietary interventions can lead to self-satisfaction and lower stress levels. Lifestyle changes are important for lowering stress for people with type 2 diabetes. Reducing job stress that is inevitable can be accomplished with daily exercise, meditation, spending more time with friends and family or volunteering to help others.
The new study is a first to show that how we perceive stress that might be related to everyday life events, or for some people, a personality trait, could raise the risk of coronary heart disease by as much as 27%. More studies are needed to understand the biological reasons for the finding.
Columbia University Medical Center
December 17, 2012
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