Stress Breaks Hearts
Emotional Stress Alters Heart Function, Ups Heart Disease Risk
Sept. 20, 2007 -- Here's a health fact most of us understand better than our
doctors do: Emotional stress really can harm our hearts.
Intense grief, acute anger, and sudden fear can have direct -- sometimes
fatal -- effects on the human heart. And long-term emotional stress shortens
lives by increasing the risk of heart disease, notes Daniel J. Brotman, MD,
director of the hospitalist program at Johns Hopkins Hospital, Baltimore.
"What is intuitive to people is not necessarily intuitive to
physicians," Brotman tells WebMD. "Emotional stress, conceptually, is
the same thing for cardiovascular risk as physical stress. But a lot of doctors
blow that off, because they think emotional stress is a psychological problem,
not a physical problem."
To overcome this false impression, Brotman and colleagues reviewed recent
studies looking at the short- and long-term effects of emotional stress on the
heart. Their resulting report, "The Cardiovascular Toll of Stress,"
appears in the Sept. 22 issue of The Lancet.
"In the hospital, I see people under all sorts of stress all the time --
and I see what happens to bodies under stress," Brotman says. "Our
study illustrates how important the body's stress responses are in
precipitating cardiovascular effects."
Heartache, Heart Harm
Psychological disorders, personality types, and other psychological
stressors are linked to various heart problems:
- People who suffer from depression, hopelessness, or a pessimistic outlook
are more likely than others to suffer
heart attack and sudden
heart death. They are more likely to develop conditions that increase heart
risk, such as obesity, diabetes, high blood pressure, and impaired heart
- People who suffer chronic anxiety are more likely than others to suffer
heart attack, atrial fibrillation, and sudden heart death. Their propensity for
high blood pressure and impaired heart rate increases their heart risk.
- Emotional trauma -- such as the death of a spouse, mental or physical
abuse, or posttraumatic stress disorder -- increases risk of heart attack and
- People with type D personalities (characterized by pessimistic emotions and
inability to share emotions with others) and type A personalities
(characterized by anxiety directed outward as aggressive, irritable, or hostile
behaviors) are more likely than others to suffer heart attacks.
- People with angry or hostile temperaments are more likely than others to
suffer heart death.
- Acute fear, grief, startling, or anger can cause "stunned heart."
Wallops of emotion also can cause sudden
death due to life-threatening abnormal heart rhythm.
Even when intense bouts of emotion don't kill, they may cause long-lasting
"Most people who suffer the death of a loved one are not coming to
medical attention, but that does not mean their hearts are not stunned for a
period of time," Brotman says. "We doctors only see those with heart
failure, or those with already-damaged hearts whose defibrillators fire. But
probably, in every body, what stress hormones do today have some impact on how
healthy your cardiovascular system will be 20 years from now."