How Does Stress Affect Heart Disease

Heart Disease

How does stress affect heart disease, especially cardio-vascular health? In a major stress situation, the heart produces about five times the output of the heart when it is at rest.To understand what happens with your arteries and blood vessels, we can easily understand this if we take a look at the principles behind using garden hoses.

You want to pick the hose that will allow you to spray water across the last ten feet with the most force. The first hose has a diameter of 3 feet and its walls are made of soft expanding material. The second hose has a diameter of one inch and is made of a tough, rigid material.

Which hose do you choose?

If you pick the second hose, the water from the tap will come streaming out with a lot of force. the narrowness and rigidity of the hose will create a huge amount of water pressure and you'll put your fire out.

Arteries that are stiff and narrow create high blood pressure. So how does stress affect health?. Part of the response to major stress is that your sympathetic nervous system in conjunction with glucocorticoids, constricts some of your major arteries.

Due to your major blood vessels being constricted, blood is now being delivered with greater speed to exercising muscle. At the same time there is a dramatic decrease to unessential parts of your body that supply blood to your digestive tract, kidneys and skin. Your body also stops processing water in the form of urine and sends it back into your blood stream via the kidneys.

This is all great if we're escaping from a man-eating lion. Blood volume is up. It is roaring through your body with more force and speed and it is being delivered to where it is needed.

But, if you put your heart, blood vessels and kidneys to work in this way every time your teenage son or daughter agitates you, you increase your risk of heart disease

Your cardio-vascular system is not adapted to enduring, prolonged psychological stress.

Your heart is just like a dumb, simple mechanical pump. Your blood vessels are nothing more exciting than hoses. The cardiovascular stress-response basically consists of making them work harder for a while.

One of the features of your cardiovascular system, is that, it branches out from your aorta to smaller blood vessels and even smaller ones down to the thousands of your capillaries. This makes it particularly vulnerable to injury. The points where the vessels branch out bear the brunt of high pressured blood that slam into them causing turbulence and wear.

With chronic increase in blood pressure that accompanies repeated stress, damage begins to occur at branch points in arteries throughout the body. The smooth inner lining of the vessels begin to tear, scar and pit. Once this layer is damaged, the fatty acids and glucose that are mobilized into your blood stream by the onset of the metabolic stress-response begin to work their way underneath this layer and stick there, thickening the lining.

During stress, your nervous system makes your blood more viscous. Specifically, adrenaline(epinephrine)makes circulating platelets that promote clotting more likely to clump together. If there are tears in some of the linings of your vessels, those clumps will build up there thus adding to the problem.

Cells full of fatty nutrients, called foam cells, begin to form there too. Before you know it, your vessels are beginning to clog and blood flow through them decreases.

Chronic Stress Causes Atherosclerosis

Psychological stress can be caused by social standing. It as been shown through physiological studies conducted by Kaplan, that both subordinate social roles (last in the pecking order) causes stress and dominant social roles (being the star of the show)also causes stress. In both cases atherosclerosis is prevalent which may lead to an heart attack -an abrupt blockage of one or more of your coronary arteries.Secretion of stress hormones, such as adrenaline(epinephrine), noradrenalone(norepinephrine) and glucocorticoids make the atherosclerosis worse. Secretion of large amounts of these stress hormones on a regular basis is a prescription for trouble.

If you form enough atherosclerosis plaques to seriously obstruct flow to the lower half of the body, you get claudification, which means that your legs and chest hurt like crazy for lack of oxygen and glucose whenever you walk.

You are then a candidate for bypass surgery.

If the same thing happens to the arteries going to your heart, you can get coronary heart disease , myocardial ischemia and all sorts of horrible things.

If the same thing happens with the blood vessels going to your brain, you can have a stroke - a brain hemorrhage.

Myocardial ischemia is the condition that arises when the arteries feeding your heart have become sufficiently clogged that your heart itself is partially deprived of blood flow and thus of oxygen and glucose.

What happens if you're suffering from chronic myocardial ischemia. You're in trouble.

The coronary arteries, instead of vasodilating in response to the sympathetic nervous system, vasoconstrict. These already clogged small blood vessels that divert blood right to your heart, just when your heart needs more oxygen and glucose, acute stress shuts them down. The exact opposite of what you need.

So, how does stress affect heart disease? Your chest will hurt like crazy - angina pectoris. It only takes brief periods of hypertension to cause this problem. So myocardial ischemia from atherosclerosis caused by chronic prolonged stress, sets you up for, at least, terrible chest pain every time anything physically stressful occurs.

Since the advent of the ambulatory electrocardiograph, doctors have been surprised to find out that people at risk can have crises that can be triggered by all sorts of psychological stress situations. Like public speaking, pressured interviews, exams.

Once the cardiovascular system is damaged, it appears to be immensely sensitive to acute stressors, whether physical or psychological.

Sudden Cardiac Death

The actual causes are hard to study because it's difficult to predict when it could happen and it's impossible to interview people afterwards.

A number of events have been documented that are associated with Sudden Cardiac Death:

• the collapse, death or threat of loss of someone close
• acute grief
• loss of status or self-esteem
• mourning
• on an anniversary
• personal danger
• threat of injury
• recovery from a threat
• triumph or extreme joy
• extreme fear.

How does stress affect heart disease? The general consensus amongst cardiologist, is that sudden cardiac death is simply an acute version of stress. It has been shown at autopsy, that even people with no history of heart disease and increase blood flow in the coronary vessels, that these people had a fair amount of atherosclerosis.

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