Years of research has shown that chronic stress can have serious consequences on the health of your heart, and even your entire body.
For years, we’ve focused on risk factors like high blood pressure and high cholesterol, but are only recently turning our attention to how our mental health can impact our physical health.
Due to the pandemic, this past year in particular has been incredibly stressful for most of us. And so you may be wondering: what impact is that having on our hearts?
Chronic Stress and the Risk of Heart Disease
Evidence is mounting that psychological factors can increase your risk of heart disease. While we’ve known for some time that discrete, traumatic stress resulting in post-traumatic stress disorder (PTSD) is a particularly potent risk factor for cardiovascular disease, cumulative exposure to daily stress can also increase risk of heart disease.
One meta-analysis focusing on patient-perceived stress levels found that individuals reporting high-stress levels, regardless of cause, had a 27% increased risk of heart disease. Another study that looked specifically at work-related stress found a 40% increased risk of heart disease. Other sources of stress, including social isolation and financial hardship, have also been linked to an increased risk of heart disease.
Anxiety, depression, and excessive anger may also increase this risk. In contrast, several indicators of positive psychological health, such as optimism, resiliency, and a sense of purpose, have been associated with a reduced risk of heart disease.
How Does Stress Lead to Heart Disease?
There are several different pathways by which stress can cause heart disease.
First, stress revs up certain biological processes that can directly increase our risk of heart disease. Psychological distress has been shown to lead to activation of our sympathetic nervous system (our “fight or flight” response) that increases heart rate and blood pressure.
It also supercharges a part of our hormonal pathway that leads to increases in stress hormones like cortisol and catecholamines like adrenaline. Inflammation, increased clotting, impaired glucose control, vascular dysfunction, and worsening cholesterol levels have also been found to result from chronic stress.
Indirectly, stress also makes it more difficult to engage in healthful behaviors that we know reduce our risk of heart disease. Individuals dealing with significant chronic stress are more likely to smoke, exercise less, and keep a poorer diet. I don’t know about you, but when I’m feeling stressed, a decadent slice of chocolate cake sounds a whole lot better than a salad!
Does Meditation and Mindfulness Help?
Meditation, a practice that focuses attention inward and invites destimulation, mindfulness, and concentration, has been increasing in popularity.
Meditation has been found in several trials to lower blood pressure modestly (in one meta-analysis about 4 mm Hg systolic), reduce stress and anxiety, and help people quit smoking through de-stimulation, and rest of the prefrontal cortex (our decision-maker).
Several small trials have expressed a significant reduction in risk of heart attack and death from heart disease in both people who have established heart disease and those at risk for heart disease. Though these trials are a great beginning, they were quite small, and of modest quality and so require replication.
Additionally, in a recent meta-analysis on mindfulness-based interventions — which included mindfulness-based stress reduction techniques (MSBR), mindfulness meditation, and mindfulness-based cognitive behavioral therapy — patients with heart disease were found to express improvements in psychological health and specifically reductions in systolic blood pressure.
While there are many types of meditation, some are more heavily studied than others.
One well-studied type related to heart health is transcendental mediation – a form of meditation in which the practitioner focuses on a personal mantra for 20 minutes twice a day. Mindfulness meditation, which centers on focused attention and observation without judgment, is also proven to reap similar benefits.
So What Can I Do?
The mind-heart-body connection is real. Our mental health is a crucial part of our overall wellness, including our heart health. Disruption of psychological health is linked with increased risk for heart disease – both by directly activating our stress response system as well as promoting chronic, unhealthy behaviors.
Your doctor should be asking you about your stress levels and offering you suggestions to help you mitigate it. Interventions, stress-reduction techniques such as meditation, and other mindfulness-based practices have been demonstrated to reduce stress, cardiovascular risk factors, and possibly also risk of heart attack. If you can, try to incorporate some amount of stress reduction or mindfulness-based practice in your daily life. Consider doing 10 minutes of meditation, walking in nature with your family, gratitude journaling, or yoga.
We must nourish our mental health as much as our physical health if we want to take care of our hearts and bodies.