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Stress and Heart Disease Risk: Effective Management Tips & Techniques

By Dr. Rajiv Agarwal in Cardiac Sciences , Cardiology , Interventional Cardiology

Jul 29 , 2024 | 3 min read

'My life is in the hands of any rascal who chooses to annoy and tease me." So said the 18th-century Scottish surgeon and anatomist John Hunter, who prophetically died of a heart attack brought on by an argument at St George's Hospital, London, concerning the admission of students!

We have always known that stress can kill. The term "she died of a broken heart" is not just poetic but can be a medical reality, though, thankfully, such extreme examples are rare. More common and important is the fact that those who have personal or job stress, depression, or loss of a loved one, especially a spouse, are about twofold more likely to have a heart attack.

There are various theories about how the ill effects of stress on the heart can happen, including an inborn "fight or flight response" with increased brain alerting activity and hormones. This can lead to fast pulse and blood pressure, over-breathing and even reduced immunity. It can also cause electrical rhythm disturbance, which can be fatal, presumably, for Dr Hunter. We often talk about stress, but it isn't easy to pin down, measure, or even define. Stress is distinct from stressors, a staple feature of modern life. Some people may be in constant high-pressure situations yet are unfazed. So, stress is our response to the stressors. If you stop enjoying the pressure, it's time to worry, pause, and maybe re-balance your life.

Conventional risk factors like high blood pressure, diabetes, cholesterol and smoking, obesity, lack of exercise, etc., are related to faulty lifestyles but account for only a minority of cases of heart attack. In many instances, we create stress that contributes to coronary-prone behaviour. Some dangerous traits like excess anger, hostility, aggressiveness, time urgency, inappropriate competitiveness and preoccupation with work have been called Type A personality or coronary-prone behaviour. Its mitigation is essential for a healthy lifestyle.

Sleep pattern also matters, and the American Heart Association now recognises 6-8 hours of good quality sleep as an essential component of a healthy lifestyle.

Some ways to prevent/manage the stress in your life include:

Avoid stressful situations, including realistic goals in work and life.
Exercising 30 minutes daily.
Eating a healthy diet of fruits, vegetables, and whole grains.
Stopping smoking.
Limiting alcohol intake.
Managing stress by having quiet downtime and participating in meditation, prayer, reading, yoga, and other relaxation techniques.
Bonding with family and friends. Expressing your feelings.
Making and keeping an appointment with a physician.

Most people would be hesitant to go to a doctor or psychologist simply for stress management, and we should be cautious not to medicalise daily life. However, stress management is crucial to work-life-family balance, mental peace, and a healthy heart. Relaxation techniques can include yoga, meditation, bio-feedback, and recreation. Fortunately, much of this can be achieved without medical intervention. A qualified yoga instructor or lifestyle coach may teach the correct pranayama technique and various asanas, which improve physical, mental, and spiritual health, lower heart rate and high blood pressure, and reduce heart disease.

The cardiologist is usually too busy to offer more than rote advice to reduce stress. However, many patients may need a formal cardiac rehabilitation program, especially after a heart attack, to overcome fear, phobia, and depression. Counselling sessions by psychiatrists and clinical psychologists are also available. These professionals can also help in de-addiction to tobacco and alcohol and handle the associated stress.

Most people instinctively recognise the importance of stress for their health but mostly lament about it. Stress management should be pursued as a worthy and impactful health activity. Doing so will contribute to being among the "lucky" ones who avoid heart disease. While pursuing Gross National Income, we should also be mindful of Gross National Happiness.

Dr. Rajiv Agarwal, MD, DM Cardio, Principal Director of Cardiology, Max Smart Superspeciality Hospital, Saket, New Delhi