A Heartfelt Approach: Managing Stress to Protect Cardiovascular Health
When we consider ways to stay heart-healthy, we often think of lifestyle factors such as what foods we eat, and how much exercise we do. While these factors have a huge role to play in maintaining a healthy heart, there is another aspect of our wellbeing that can impact our cardiovascular health: our mental health. The connection between our mind and heart is a complex one, and recent studies are beginning to show how our mental health can have an impact on our cardiovascular health.
What Is Stress, and How Can It Cause Cardiovascular Disease?
Stress – a state of worry or mental tension caused by a difficult situation – can play a key role in the development of mental health issues and is a significant contributor to cardiovascular disease (CVD) risk.1 When we talk about stress and the heart, we mean immediate fight-or-flight changes and longer-term patterns that can influence cardiovascular risk.
Stress responses can be adaptive, such as when it helps us to deal with a threat, or maladaptive, such as when it interferes with our health.2 Today, we often experience unmitigated maladaptive stress, which can result in a negative impact on our health and happiness.3
Through the activation of physiological systems such as the sympathetic nervous system, which mediates the fight-or-flight response, stress induces an array of responses such as: the release of hormones including cortisol, an increase in heart rate and blood pressure, and also a suppression of the immune system.1,4
Acute vs Chronic Stress: Heart Rate, Blood Pressure, Cortisol
While stress responses can have positive effects in the short-term, chronic stress can lead to sustained effects, and evidence links chronic stress and cardiovascular disease and cardiovascular events.5
Similarly, vital exhaustion (commonly referred to as burnout) is something typically caused by chronic stress, and has been shown to lead to a 20% increase in the risk of developing atrial fibrillation – a condition that is often the cause of blood clots forming, which can lead to stroke, heart failure, and other CV complications.6,7
The Effect of Stress on Heart Health
People often ask about ‘heart problems caused by stress; current evidence shows associations rather than a single direct cause. Stress can aggravate symptoms such as palpitations and may make some rhythms feel more noticeable; part of the effect of stress on heart rhythm is heightened awareness of normal beats, though persistent irregular rhythms still warrant assessment. If you have new or worsening palpitations, dizziness or chest pain, seek medical advice.8
Stress management: practical, evidence-based steps
However, there are several measures that can be taken which could help to reduce CVD risk from stress, and other associated mental health issues:
- Stress management techniques such as mindfulness have been shown to improve mental health and are associated with less stress and higher levels of well-being.9 Additionally, higher levels of mindfulness are associated with a lower likelihood of having cardiovascular risk factors.9
- It is known that exercise can directly reduce the risk of CVD, by reducing risk factors such as high blood pressure and cholesterol levels – however, recent evidence also suggests that partaking in exercise may also be more effective for improving mental well-being when compared to medication, or even therapies such as psychotherapy.5,10
- Management of mental health issues such as depression through the use of psychotherapies, including talking therapy, has also been shown to have an impact on cardiovascular health. Evidence suggests that people who saw an improvement in their symptoms of depression after taking part in talking therapy also had a 10–15% lower risk of cardiovascular disease, compared to those who saw no improvement in their depression symptoms following therapy.11
Small changes can make a meaningful difference. Try one or two of the following activities to reduce your stress level:
- One-minute breathing: breathe gently into the belly through the nose, out through the mouth; count 1–5 in and 1–5 out for 3–5 minutes.12
- Mindfulness basics: brief “attention to breath” exercises can reduce stress reactivity.13
- Gentle movement: walking and stretching support mood and heart health. Yoga may help relaxation (as an addition, not a replacement for aerobic activity).14
- Talk to someone: If stress is affecting your daily life, contact your healthcare provider.15
Caring for the Heart, Mind and Body: A Holistic Approach to Cardiovascular Health
At the European Society of Cardiology congress, we have been working with Claudia Garbrecht, a psychologist and fitness trainer, to host an interactive booth event discussing the importance of cultivating better heart health by taking care of mental health and well-being. “Being able to recognise the link between stress and cardiovascular health is vital in identifying the significance of a holistic health approach to overall cardiovascular well-being. While lifestyle factors such as diet and exercise are known to directly improve cardiovascular health, they only represent a couple of pieces in the puzzle that helps to explain how CVD develops. Because of this, I believe that true well-being comes from a holistic approach of looking after both your mental and physical health!”
At Daiichi Sankyo, we care for every heartbeat, and we understand that no single approach to improving cardiovascular health works for everybody. That is why we believe a holistic approach that brings together a variety of healthcare experts is needed if we are to help reduce the impact of CVD across Europe.
