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World Heart Day 2023: Can Stress Lead To Heart Attacks? Know Connection Between The Two

Excessive stress can harm the body, increasing the risk of heart disease and strokes. It can also lead to high BP, heart attacks, and heart rhythm disturbances.

Stress is a natural part of daily life, originating from our ancient fight-or-flight instinct. It prompts the release of stress hormones, aiding us in facing challenges. Yet, in the current scenario, excessive stress can harm the body, increasing the risk of heart disease and strokes. It can also lead to high BP, heart attacks, and heart rhythm disturbances.

We all know about the fact that stress can have negative effects on our health and can become a reason for silent heart attacks. Doctors have long been intrigued by the link between stress and heart attacks. Recent studies have revealed the complex relationship between the two concepts. Additionally, stress can collectively affect your mood and damage your heart. 

In this regard, Dr. Rushikesh S Patil, who is a Full Time Consultant Interventional Cardiologist at Dr LH Hiranandani Hospital, Powai, Mumbai said, "The body's health totally depends on the relationship between stress and the heart. When we are under stress, our stress hormones like cortisol and adrenaline get released in large amounts. These hormones result in high blood pressure and pulse rate. Stress can take an individual towards bad and unhealthy habits like alcohol consumption, smoking, etc."
 
"Prolonged stress is the main reason for chronic diseases. This may result in atherosclerosis, a condition in which arteries get accumulated with plaque. Due to this accumulation, blood flow towards the heart gets constrained. Excess intake of oil and cholesterol-rich food can result in heart blockage. Dirt in the form of plaque gets stuck on the artery walls. For this, angioplasty is performed as the last treatment," he continued to say.

In addition to him, Dr. Sunil Dwivedi, consultant cardiologist at Manipal Hospital Miller's Road said, "Continual stress can elevate blood sugar levels and contribute to diabetes. Stress can be managed by incorporating physical and mental exercise in your day-to-day lives, like relaxation exercises and activities like brisk walking, deep breathing, and seeking support from friends."

Risk Factors Of Heart Diseases:
 
Dr. Punish Sadana, who is the Associate Director – Dept. of Cardiology, at Max Healthcare, Dehradun said, "Heart disease stands as the foremost cause of mortality among both men and women. Traditional risk factors for heart disease encompass high blood pressure, elevated cholesterol levels, smoking, diabetes, obesity, and a sedentary lifestyle."
 
"However, alongside these well-recognized risk factors, non-traditional elements like stress, anxiety, and depression have garnered increasing attention for their influence on heart health. Many individuals, at some point in their lives, encounter psychological trauma or significant stressors, such as the loss of a loved one, a life-threatening diagnosis, natural disasters, or experiences of violence. It is within this demographic that we find those susceptible to stress-related heart attacks," he added.
 
Psychological Stress As An Independent Risk Factor For Heart Attacks:
 
Dr. Punish Sadana said that studies have unequivocally demonstrated that psychological stress stands alone as an independent risk factor for heart attacks.
 
"Prolonged and recurring stressors trigger immune system responses that contribute to chronic inflammation. This inflammation, in turn, sets the stage for atherosclerosis, the narrowing and hardening of arteries, thereby restricting blood flow to the heart and heightening the risk of a heart attack. Emotional stress has the capacity to elevate blood pressure, leading to hypertension, a precursor to heart disease."
 
"Moreover, stress induces the release of stress hormones, most notably cortisol, which impacts blood platelets and the autonomic tone, responsible for regulating involuntary bodily functions, including heart rate and blood pressure. These intricate interplays between stress and physiological responses all contribute to the development of heart disease," he continued to say.
 
"Furthermore, stress can instigate unhealthy coping mechanisms, such as overeating or substance abuse, and deter individuals from engaging in physical activity, thereby compounding the risk of heart disease. Acute stress episodes temporarily elevate the likelihood of cardiovascular disease (CVD). In cases of severe stress or intense emotional turmoil, an unusual condition known as takotsubo cardiomyopathy, or 'broken heart syndrome' can manifest," he added.
 
Diagnostic Tests To Understand Link Between Stress And Heart Attacks:

Dr Sushrut Pownikar, who is the Head Of Quality Assurance and Deputy Director, at Oncquest Laboratories, New Delhi said, "In order to fully understand the complex link between stress and heart attacks, diagnostic tests are crucial. There are many diagnostic tests and procedures to evaluate the effects of stress on the cardiovascular system."

He further went on to list some of them:

  • Measuring biomarkers like high sensitivity C-reactive protein (Hs CRP) and cortisol, which show higher levels in situations of chronic stress and inflammation, and contribute to heart disease, is one such important testing strategy. Blood tests measure these indicators, which help physicians identify at-risk patients.
  • High sensitive Troponin I (HsTnI), is also one such test that can be used as a specific biomarker in predicting future cardiac events.
  • Additionally, the impact of stress on lipid metabolism is carefully examined. Stress can cause changes in cholesterol levels, especially an increase in LDL cholesterol, sometimes referred to as 'bad cholesterol', which is a recognised risk factor for heart disease. To monitor these levels and their relationship to stress-induced disease, diagnostic laboratories examine lipid profiles.
  • In reaction to stress, blood pressure, a significant risk factor for heart attacks, is also closely monitored. To assess the effects of persistent stress on blood pressure patterns, diagnostic/ clinical laboratories take routine blood pressure readings and carry out ambulatory blood pressure monitoring.
  • Electrocardiograms (ECGs or EKGs) are crucial diagnostic tools for identifying heart attacks and assessing cardiac problems caused by stress. To detect any anomalies in heart function brought on by stress, diagnostic laboratories also perform stress tests, such as exercise stress testing or pharmacological stress tests.
  • Moreover, cutting-edge imaging methods like CT angiography and cardiac MRI are used to produce in-depth pictures of the heart and coronary arteries. These methods of diagnosis can detect coronary artery disease, which can be made worse by stress.
  • Since prolonged stress can cause low-grade inflammation, which aids in the development of atherosclerosis and arterial plaque, inflammatory indicators are carefully examined in diagnostic laboratories. To quantify the inflammatory response linked to stress, markers such as tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) are examined.
  • Another important component of stress-related cardiovascular examination is hormonal analysis. Adrenaline and noradrenaline are released when the sympathetic nervous system is activated by stress. Acute impacts of hormone levels on heart function are assessed in diagnostic labs, revealing important details about the circulatory response to stress.
  • In addition, Holter monitors and other continuous heart rate and rhythm monitoring tools are used to identify arrhythmias, or abnormal heartbeats, which are made worse by stress. 
How To Manage Stress?
 
Stress, being an intrinsic part of life, requires careful management to mitigate its potential deleterious consequences. Identifying effective stress management techniques tailored to individual needs can take weeks or even months. However, it is imperative to reverse the physical repercussions that chronic stress imposes on the body.
 
Dr. Punish Sadana said, "In circumstances where stress is unavoidable, acquiring relaxation skills like practicing deep breathing exercises, yoga, meditation, or engaging in one's hobbies can be instrumental. Physical activity and maintaining social connections also prove beneficial in stress reduction. Social interactions serve as effective stress alleviators by offering distraction, emotional support, and the means to navigate life's challenges. Consider taking breaks with friends, reaching out to relatives, or seeking solace in religious or spiritual practices as part of your stress management toolkit."
 
"If you recognize any symptoms like chest pain, loss of breath, etc. then consult your doctor first. Keep your heart at the first priority and keep a gap in your personal and professional lives. Always keep in mind that if your heart is healthy, everything will work as per your choice, but if it is unhealthy everything will get disturbed from your family to your work life," Dr. Rushikesh S Patil added.
 
Dr. Amit Kumar Chaurasia, who is the Chief Cath Lab & TAVI (Unit I), Artemis Hospitals, Gurugram concluded, "While stress itself is not the sole cause of heart attacks, it plays a significant role in their development by contributing to risk factors, promoting inflammation, and affecting lifestyle choices. Recognizing the connection between stress and heart health is essential for individuals and healthcare providers to develop effective strategies for prevention and management. Reducing stress and adopting a heart-healthy lifestyle can go a long way in mitigating the risk of heart attacks and promoting overall well-being."
 
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
 

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