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What is the effect of Psychosocial Stressors on Heart Health?

Introduction

The modern workplace and life are a significant source of stress for many individuals, driven by various factors such as long hours, tight deadlines, job insecurity, and high demands of daily duties. We often get questions from our patients about the impact of stress at work and life on heart health.
The mechanisms through which stress influences heart health are multifactorial. Stress activates the body’s “fight or flight” response, leading to the release of stress hormones such as adrenaline and cortisol. These hormones increase heart rate and blood pressure, providing a short-term boost in our physical performance. However, chronic activation of this response can lead to possible heart disease through development of coronary heart disease, details of research evidence below.

Three studies describing the effect of stress on heart health.

In 2004 a study published in Lancet concluded that: ‘Presence of psychosocial stressors is associated with increased risk of acute myocardial infarction, suggesting that approaches aimed at modifying these factors should be developed.’ (https://pubmed.ncbi.nlm.nih.gov/15364186/) Meaning that stress at work can unfortunately lead to heart attacks.
In addition to this, a study published European Heart Journal in 2013 showed that people, who reported at baseline that stress has affected their health ‘a lot or extremely’ had a 2.12 times higher risk of heart attack or dying from heart attack, when compared with those who reported no effect of stress on their health. (https://pubmed.ncbi.nlm.nih.gov/23804585/)
Finally, a study published in 2023 in Circulation: Cardiovascular Quality and Outcomes demonstrated that exposure to psychosocial stressors such as job strain and effort-reward imbalance led to increased risk of Coronary Artery Disease. In men exposure to one of the above stressors caused 49% increase of an adjusted risk of Coronary Heart Disease, exposure to both 103% risk increase. In women results were inconclusive. (https://pubmed.ncbi.nlm.nih.gov/37724474/)

Lifestyle Factors and Stress Management

Lifestyle choices significantly influence the relationship between stress and heart health. People, who experience high levels of stress often engage in unhealthy behaviours including smoking, alcohol misuse or suboptimal diet and physical activity. Conversely, adopting a healthy lifestyle can positively affect the stress levels and overall heart health. Regular physical activity is one of the most effective strategies for managing stress and improving cardiovascular health. In addition to this mindfulness and relaxation techniques, such as meditation can reduce stress and improve heart health.

Conclusion

Work and life stress is a significant risk factor for heart health, contributing to the development of cardiovascular diseases through various mechanisms. The evidence points towards a direct link between stress and coronary artery disease. Several possible mitigating activities exist to reduce the stress and overall heart health.

Author : Dr Bart Olechowski

Author : Dr Bart Olechowski

Consultant Interventional Cardiologist in Hampshire, UK.

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