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By Libby Pellegrini MMS, PA-C
February 04, 2021
One key aspect of heart health may be your state of mind, according to the American Heart Association (AHA). In a recent statement published in the journal Circulation, the AHA acknowledged the profound impact that psychological stress can have on cardiovascular health and the development of cardiovascular disease.
Have you ever felt a stab of chest pain during a wrenching movie scene, or sensed heart-fluttering palpitations during a romantic one? You may have been experiencing the mind-heart-body connection firsthand. Researchers are finding that the brain and heart are connected through a variety of interdependent processes that are not only transient, but can also have long-term health implications.
At the most basic level of the mind-heart-body connection, psychological health influences behavior. It follows that people with negative psychological health (which the AHA qualifies as stress, pessimism, depression, anxiety, anger, or hostility) may be more likely to adopt behaviors that negatively impact the heart, such as initiating a smoking habit, overeating, not complying with their medication regimen, or being sedentary.
While behavior alone can increase cardiovascular risk, the cardiac impact of negative psychology transcends mere behavioral changes. Studies have shown that negative psychological health—be it anxiety, depression, or even PTSD—can affect biological processes such as hormonal regulation, nervous system function, inflammation, and blood coagulation.
These biological changes can, in turn, affect the stiffness of the heart arteries and the way that the heart cells function, leading to increased morbidity and mortality from cardiovascular disease. In fact, some research has shown that people with a high stress level may have a 27 percent increased risk of cardiovascular disease.
Even lesser-studied psychological stressors, such as loneliness and social isolation, may influence heart health in both humans and other animals. In fact, chronic social isolation and loneliness may increase one’s cardiovascular risk in an amount that is equivalent to smoking 15 daily cigarettes or consuming six alcoholic beverages a day.
So, is a happy heart a healthy heart and a sad heart a sick heart? Potentially. Because your psychological health can affect your actual biological inner workings, you can positively benefit your cardiac status by addressing any underlying mental health concerns.
The American Heart Association has identified the following specific psychological features that may be associated with improved cardiovascular health, including:
One of the most notorious examples of the mind-heart-body connection is a condition known as Takotsubo cardiomyopathy (or stress-induced cardiomyopathy), which occurs most commonly in middle-aged women. In this condition, an extremely stressful or grief-inducing event (such as experiencing the loss of a loved one or living through a natural disaster) can cause the heart muscle in the wall of a specific heart chamber, known as the left ventricle, to physically weaken. When the heart muscle contracts, this weakened wall balloons outward, triggering signs and symptoms of a heart attack that are indistinguishable from a true heart attack.
People with Takotsubo cardiomyopathy (colloquially known as “broken-heart syndrome”) may even initially be suspected to have had a heart attack. However, further investigations typically reveal the true diagnosis. Though it may be painful and frightening, Takotsubo cardiomyopathy generally resolves completely in a few weeks without medical intervention.
If you are feeling depressed or anxious, your first step should be checking in with a mental health provider. However, after formally addressing your mental health concerns, the American Heart Association recommends exercise and meditation as a way to positively impact your cardiovascular health. There’s nothing to lose. Adding these measures to your routine can make you feel better mentally and also reduce your risk of developing cardiovascular disease, the leading cause of death in the United States.
Libby Pellegrini is a nationally certified physician assistant. She has worked in numerous healthcare settings, including the rural United States, an inner-city Level I trauma center, several suburban acute care centers, and a boutique, personalized medicine clinic in Southeast Asia. She graduated Magna Cum Laude from Northwestern University’s Medill School of Journalism.
Resources:
https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000947
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831910/
https://www.wellrx.com/health-conditions/about/health-condition/atherosclerosis/~default/
https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome
https://www.wellrx.com/health-conditions/about/health-condition/heart-attack/~default/
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