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    Lighten Up

    A chuckle a day

    WebMD Feature
    Reviewed by Craig H. Kliger, MD

    Feb. 5, 2001 -- If you're serious about reducing your heart attack risk, it can seem like a full-time job. You need to eat right: easy on the fat, fried foods, and red meat. You should exercise regularly, including plenty of cardiovascular conditioning. And you must control stress. It's quite a tall order.

    Now comes another suggestion that's easier to follow: Don't forget to laugh.

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    Laughter is being called the latest weapon in the fight against heart disease, ever since University of Maryland researchers reported at an American Heart Association meeting in November that heart-healthy people are more likely than those with heart disease to laugh frequently and heartily, and to use humor to smooth over awkward situations. There's even hope, the scientists say, for cranky people who rarely laugh and for those without a sense of humor: They can learn.

    In the study, Michael Miller, MD, director of the Center for Preventive Cardiology at the University of Maryland Medical Center, Baltimore, and his colleagues asked 150 people who had suffered heart attacks or undergone heart bypass surgery for their reactions to situations such as arriving at a party to find someone wearing identical clothing, or having a drink spilled on them by a waiter. They compared the responses -- and especially their tendency to laugh -- to those from 150 healthy control subjects (matched for age) without heart problems.

    Turns out that the healthy people were more likely to laugh often and to use humor to get out of uncomfortable situations. Those with heart disease, on the other hand, were 40% less likely to laugh in those situations.

    The value of a laugh

    Exactly how laughter may protect the heart isn't entirely understood, says Miller. But some evidence suggests that the effects of a chortle, snicker, or guffaw include reduction in stress hormones such as cortisol, and reduction in blood pressure. That in turn may reduce heart disease risk. It is known that mental stress can impair the endothelium, the protective barrier lining the blood vessels, Miller says.

    Besides those physiological effects, Miller says, there may be additional mechanisms to explain why laughter is good for your heart and your health. He hopes to discover more during his next study, scheduled to start in the spring.

    The setting in which you laugh may be important, says Adam N. Clark, MD, a fellow in cardiology at the University of Virginia, Charlottesville, and a co-author of the study. Usually, you laugh in a group or with at least one other person (although Clark is quick to point out there's nothing wrong with a good belly laugh when you're by yourself). But the social aspect of laughing may be a plus, Clark says, because isolation can be associated with depression.

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