Home Am I at Risk? Stress and Heart Risk

Stress and Heart Risk

What is stress?

Stress is a mentally or emotionally disruptive condition that occurs in response to outside influences. It is usually characterized by a faster heart rate, a rise in blood pressure, tensing of the muscles, irritability, and depression.

Can stress affect my risk of heart disease?

Yes. However, when researchers talk about the effects of stress, they speak specifically to the kinds of events that trigger this response. Many of these triggers are short term, such as experiencing a death in the family or surviving a car crash. However, stressors that are likely to affect your risk of heart disease are more long term. They are often called chronic stressors. Chronic stressors include those discussed below.

Lack of social support

Social support is the friendship, encouragement, and companionship that family and friends provide. People with fewer connections to friends and family have a higher risk of heart disease and heart attack.41-45 In a review of 15 studies that examined the effects of social factors on heart disease, having a relatively small network of family and friends increased a person’s risk of having heart disease 2- to 3-fold over time, compared with people who have larger social support groups.7

In a study of over 500 women who likely had heart disease, those who had larger, more supportive social networks had fewer risk factors including lower blood sugar levels, lower rates of smoking, and lower rates of high blood pressure and diabetes, and were slimmer than those with smaller social circles.46

While living alone has been shown to increase the risk of heart disease in men,47 the same has not been seen in women because women are more likely than men to develop close friendships outside of marriage.48

Poverty

Not earning much money increases the risk of heart attacks in both healthy people and those with heart disease. This may be due, in part, to both the stress of poverty and reduced access to healthcare. Poverty has also been linked to poorer health habits, higher rates of heart disease risk factors, increased levels of high-risk behaviors such as smoking and drinking alcohol, and other psychosocial risk factors such as chronic stress.49-52 Researchers also think that much of the risk associated with smaller social circles could be explained by income level.46 A large, all-female study showed that women with the fewest social ties were much more likely to have an annual income below $20,000 and a low income level was significantly associated with an increased risk of death.46 Your income level is also related to the type of work you do, which may influence your stress level.

Work-related stress

The relationship between work stress and heart disease is still up for discussion. Data from a study of more than 3,000 people (44% were women) show that over 10 years, women in high-powered jobs with high degrees of authority and control had almost 3 times the risk of developing heart disease than women in high-demand jobs who had little control over the work they do, such as factory workers.53 This is different than the findings in men, where those with lots of control over their work are less likely to have heart disease than those with busy jobs but little control .54 In another large study of over 10,000 people, being stressed at work was significantly related to heart disease risk in men and women, regardless of job type.54

In a study of more than 1,300 women, having a “high pressure deadline at work” made both men and woman 6 times more likely to have a heart attack within the next 24 hours. A change in financial circumstances tripled a woman’s risk of heart attack. Women were also 3 times more likely to experience a heart attack if they had recently taken on more responsibilities at work, particularly if they were unhappy about these new responsibilities.55


However, the Nurses’ Health Study of more than 35,000 women found that job strain was not related to an increased risk of heart disease. Women in this study were between the ages of 46 and 71 and were followed for an average of 4 years. Though they were all registered nurses, they performed different jobs, some of which were more stressful than others. After adjusting for other risk factors including age and smoking, women in high-strain jobs did not have a higher incidence of heart disease compared with those in low-strain jobs, and neither women in active or passive jobs showed an increased risk of heart disease.56

Marital stress

Marital stress may be a greater risk for women who already have some form of heart disease than for those with healthy hearts. One all-female report found that severe stress in a marriage or live-in relationship can triple a woman’s risk of a second heart attack or angina.57 Marital stress may also affect risk factors. Women in the Pittsburgh Healthy Women Study who were either dissatisfied with their marriage, were divorced, or widowed were significantly more likely to develop metabolic syndrome after nearly 12 years. Single women, however, showed no significant difference from happily married women.58

Caregiver stress

Caring for people who are elderly, ill, or disabled is burdensome and stressful for many families and may lead to depression.59 Studies have shown that female caregivers are less likely to take care of their own health, and their blood pressure tends to rise when they are in the presence of the person they care for.60, 61

In the Nurses Health Study, of more than 54,000 women, those who cared for a disabled or ill spouse for 9 hours or more per week were about twice as likely to develop heart disease in the next 4 years.62 However, caring for disabled or ill parents, children, or friends did not significantly increase a woman’s risk. Other results from the Nurses’ Health Study also showed that being under strain from caregiving could increase your risk of death from any cause.59

Caring for a family member or spouse isn’t always bad for your health. The risks are not due to the act of caregiving alone, but occur only when the act is viewed as stressful.59

How can depression or stress be treated?

There are many things you can do to combat depression and stress. Finding social support either from friends and family or through a support group can be helpful. Managing your stress can also help treat depression.

There are also several different types of treatments available for women who are under a lot of stress—the key is to find the method that is right for you. Many women find that relaxation exercises and meditation help alleviate stress. Relaxation exercises involve the flexing and releasing of major muscle groups. Breathing exercises also help to reduce stress. Exercise has also been shown to be a very effective way of reducing stress because it reduces the amount of stress hormones that your body releases.63 Many cardiac rehabilitation programs also teach stress management techniques.

If you can't lower stress or depression by yourself, you may want professional help. Licensed therapists, psychologists, marriage and family therapists, pastoral counselors, clinical social workers, and psychiatrists offer short-term psychotherapy.63 A psychiatrist may also help a person overcome their depression. Talk to your doctor. There are medications that he or she can prescribe to help treat depression called selective serotonin reuptake inhibitors such as Zoloft and Paxil. Though these medications do have serious side effects, most studies show that they are safe and effective for people with heart disease.64-66 Your doctor can help you weigh the risks and benefits of using these medications.

For more information:

http://www.nimh.nih.gov/
The National Institute of Mental Health

http://www.apa.org/
The American Psychological Association

http://www.dbsalliance.org/
The Depression and Bipolar Support Alliance

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