Stress is the body’s response to factors from the external world that require us to adapt quickly, i.e. to adjust to a changing, challenging environment and current conditions. In other words, stress has the function of mobilising an action to bring about equilibrium (e.g. returning to a safe situation).
How does stress affect your heart?
As a defence, the body produces a whole set of reactions, including chemical ones, which prepare us for an immediate response, e.g. an increase in blood pressure, accelerated breathing or muscle tension. In the case of chronic stress, the experience of stressors occurs with such frequency and intensity that the autonomic nervous system does not have sufficient opportunity to regularly activate the relaxation response. This means that the body remains in a constant state of physiological arousal. Chronic stress actually affects every system in the body – either indirectly or directly. The human organism is prepared to process such a strong stressor at a not too high frequency. Potential complications associated with experiencing chronic stress include the occurrence of hypertension, heart disease, as well as diabetes and many others. Today we will focus on the effects of stress on the cardiovascular system.
In March 2022, the American Journal of Medicine published a critical review of studies confirming the link between stress and cardiovascular risk, as well as potential mechanisms by which psychological stress may contribute to heart disease and accelerate myocardial ischaemia and infarction.
The authors distinguish between a sudden, acute experience of stress and chronic stress. In the case of the former – i.e. a sudden, acute stress reaction – it was examined whether very difficult experiences such as terrorist attacks, warfare or natural disasters are accompanied by an increase in the number of patients experiencing heart disorders or death because of them. It turned out that yes! Such ‘natural’ and ‘artificial’ experiments seem to suggest that strong acute stressors can indeed accelerate cardiac ischaemia, heart attack or arrhythmia. Studies to date have looked at a significant (several-fold!) increase in the number of patients with acute myocardial infarction and sudden death after Iraq’s initial missile attacks during the Gulf War. The observations were made at the Israel Medical Centre. Another example was a study conducted after the attacks on the World Trade Center. It turned out that among the participants in the study (residents of New York), the detection of tachyarrhythmia incidents resulting in defibrillation and other cardiac incidents increased statistically significantly (detection more than doubled).
Other studies have shown that it is not only strong shocks such as war, armed attacks or natural disasters that cause an increase in cardiovascular incidents. It turns out that experiencing severe stress at work (prolonged or a single, acute event), a sporting competition (in this case, the 2006 FIFA World Cup was studied), or in general severe nervousness in response to a difficult situation, e.g. a confrontation resulting in strong anger, financial trouble or the death of a loved one are associated with a higher incidence of cardiovascular incidents.
The worldwide INTERHEART study, which involved around 25,000 participants, found that experiencing stress at work was associated with an increased risk of myocardial infarction.
In another population-based study, ‘PURE’, which involved more than 100,000 participants, researchers assessed stress levels at the start of the study. After an average follow-up period of just over 10 years, it was found that those experiencing long-term stress, compared to the rest of the study participants, were associated with a significantly increased risk of cardiovascular disease (after accounting for traditional cardiovascular risk factors).
A comprehensive review, which analysed both single studies and multiple meta-analyses, found that work stress increases the risk of ischaemic heart disease and stroke by 10-40%.
A key part of the limbic system responsible for making stress meaningful is the amygdala (it is here in the amygdala that anxiety is generated, and activation of this part of the brain causes a number of cognitive disorders). A series of studies have shown that experiencing stress in response to events that are important to us correlates with increased amygdala activity. These studies, conducted using CT scans, also showed increased bone marrow activation and arterial inflammation. During follow-up, it was noted that amygdala activation was associated with an increased risk of cardiovascular incidents.
How do we deal with excessive stress?
One of the most effective ways to deal with excessive stress and anxiety is to start psychotherapy. Approaches such as cognitive behavioural therapy can help you learn to recognise the negative thought patterns that contribute to experiencing chronic stress. Another effective way to deal with stress is to consistently apply mindfulness techniques. When severe stress is also accompanied by depression or anxiety disorders, it is a good idea to include pharmacological treatment. Another aspect that influences wellbeing is proper nutrition and physical activity.
Other ways to cope with the stressors of everyday life are to incorporate techniques that can be freely applied at home, depending on your own preferences:
- Progressive muscle relaxation in Schulz training or Jacobson training,
- Deep breathing
- Walking and staying in contact with nature
- Aromatherapy
- Exercise and physical activity
- Activity related to creativity, creation
- Assessing one’s own priorities and acting in accordance with one’s own value system
- Practicing gratitude
Of the above, choose the ones that work best for you – those that are available in the short term, those that can be done anywhere, are free and, most importantly, provide immediate relief. A final, legitimate and effective action is to eliminate stressors.
Anna Walter, psychologist