Working Smarter

The Killer Inside: How Chronic Stress Breaks Hearts

Posted by Joe Robinson

Stress and control

Of all the health problems triggered by stress, few are more vetted in the scientific literature than the connection between stress and heart conditions. A raft of studies have traced the link between job stress and cardiac issues alone. 

People who work more than 51 hours a week, for instance, increase the risk of high blood pressure by 29% (Yang, Schnall, Baker, U.C. Irvine). The study’s authors said 30% of us don’t even know we have high blood pressure, so it ticks like a time bomb inside until enough damage has occurred to an overworked heart and worn-down arteries that it results in hypertension, stroke, or heart attacks. 

Those are all counterproductive for the individual and productive output, which is one of the reasons stress management needs to be given priority attention in any organization.

WAKEUP CALL ON STRESS AND HEART ATTACKS

The latest wakeup call on the toll taken by chronic stress comes from a massive study in Sweden that looked at 137,000 people with stress-related disorders and compared their cardiovascular issues, from heart attacks to blood clots, to their unstressed siblings.  Researchers followed the participants for 27 years and found that those with high levels of stress had a 60% greater risk of a heart attack within a year of being diagnosed than their brothers or sisters without stress issues. 

In an article in the famed medical journal Lancet, Mika Kivimaki and colleagues Jaana Pentti, Jane Ferrie, David Batty, Solja Nyberg, and Marcus Jokela examined seven studies, covering 102,633 people, on the association between work stress and mortality and found that job strain in men with cardiometabolic disease (which includes everything from angina, to stroke, insulin resistance, and diabetes) has a higher rate of mortality than high cholesterol, obesity, lack of physical activity, and high alcohol consumption.

You can watch your cholesterol and drink moderately, but that won’t help you avoid the reckoning that chronic stress wreaks on your cardiovascular system. Why is stress so tough on the ticker and arteries?

BLOOD VESSELS LIKE FIREHOSES

When the stress response is activated by demands, workload, or hours beyond your perceived ability to handle them, your body goes into life-or-death mode as if the year was 150,000 B.C. to push blood to your arms and limbs, so you can fight or run from the danger. That means your heart has to beat faster and your blood pressure has to soar to pull this off.

If you don’t turn off the stress trigger, the response stays activated, turning into chronic stress. This keeps blood pressure constantly high, leading to the number one killer in the nation, cardiovascular disease.

In this state of constant activation, the blood roars through arteries like water through a firehose, a velocity that can wear down the lining inside your arteries, causing craters to develop that attract clotting and vascular obstructions. The blood races with such force that the body does something remarkable. It grows a thicker muscle layer around the arteries to keep them from flying around your body. These can then clamp down on the blood vessels, causing constrictions and cardiovascular events.

OVERUSE INJURIES

Devices we overwork break down, whether they are smartphones, cars, or hearts. Stress puts a lot of extra mileage on your cardiovascular system and particularly your heart. When high blood pressure from chronic stress becomes the new normal for months or years, that’s where the real damage occurs.

Continual high blood pressure and rapid heartbeat can cause a host of damage. The increased volume and velocity of blood balloons and inflames vessels, injuring them, and increases the odds that plaque and cholesterol will find their way to injured sites.

Chronic high blood pressure also sends blood more forcefully to the heart in a collision that impacts the heart muscle wall. This can result in left ventricular hypertrophy, an irregular heartbeat. The heart muscle is thickened from the impact of the blood flow, which puts pressure on the coronary arteries to deliver more blood than they may be able to. Left ventricular hypertrophy is one of the clearest tipoffs to an imminent cardiac event. 

Studies on mice and monkeys show that social stress increases the amount of plaque buildup in veins, or atherosclerosis. Combine that with the torrent of blood set off by high blood pressure, and those plaque particles can get swept along and shoved into smaller veins where they can cause a total blockage, or thrombus, or into coronary vessels, where they can clog the flow of blood to the heart, leading to a myocardial infarct, i.e. a heart attack.

STRESS WORSE THAN HIGH CHOLESTEROL

It’s a cruel irony, but chronic stress is the real life-or-death threat, not the social stressors that set off the bogus fight-or-flight response in our day. We have to turn off the false alarms in our brain that drive stress, dispute, challenge, and contest stress, or we put our health at a greater risk than scarfing down platefuls of high cholesterol food or smoking a pack a day.

This is why a workaholic will die before an alcoholic. An alcoholic will have a long demise, while the workaholic has a sudden exit, thanks to a heart attack that could have been easily prevented with some basic stress management strategies.

To avoid an early departure from an overworked cardiovascular system, it’s critical to get an assessment of your stress levels. As the Yang study demonstrated, almost a third of people don’t even know they are highly stressed. The adrenaline released by the stress response masks the fact the body is going down and gives you a feeling of transcendence, a sense you are handling everything. But inside your body is working overtime.

Brian Curin, a co-founder of the Flip Flop Shop sandal stores told me that he was feeling a little sluggish when out jogging. He took a treadmill stress test, and the doctor told him he needed a quadruple bypass, right then and there. He went directly from the doctor’s office into surgery. Curin was 39 years old at the time.

ASSESS YOUR STRESS

There are a number of tests you can take to assess your stress levels. The treadmill test and electrocardiogram are the best, but you can have your cortisol levels checked with a simple blood test. Cortisol is a stress hormone, and elevated levels of it can be a stress tipoff.

By all means, get your blood pressure checked, but have it done at work, which is going to produce a much more accurate reading than one done in the calm of the doctor’s office.

Stress is part of work, part of life, but if we don’t manage it, it manages us and exacts a crippling toll on what makes us tick.

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Tags: manage stress, chronic stress symptoms, stress and heart problems

The Most Dangerous Thing About Stress: How Long We Hang on to It

Posted by Joe Robinson

Burnout Woman 40562450_m

Too many margaritas can make you a traffic accident statistic. Too much sugar and fat, both of which are crucial to providing energetic resources for the body, can lead to obesity and a serious side effect, diabetes. Even too much water can kill you. If you notice a trend here, it’s that things that may be harmless in moderation can boomerang on us in excess. Add stress to the list.

The stress response was designed for short bursts, providing a sudden rush of power to our limbs to help us fight or run from life-or-death danger. It was intended to last a limited time, until we were out of harm’s way and imminent demise. When the saber-tooth tiger left the neighborhood, so did the stress.

KILL STRESS FAST

That was a good thing, since the longer stress lasts, the more damage it does to your body. Stress in small doses doesn’t wreak large-scale havoc on your innards and can even be considered an asset that propels you through a challenge or makes something feel exciting as you put your skills to a test.

On the other hand, stress that lasts days, weeks, and months, if not years, causes wide-scale harm to any number of systems and organs in the body and can lead to sudden trips to the ER. All stress management efforts should be focused on cutting off the most dangerous threat of stress, how long it lasts, and killing it before it kills you.

It’s the duration of stress that makes it so dangerous, since the stress response rejiggers many parts of your body in harmful ways to prepare your system for battle stations. Some functions of the body aren’t needed in a life-and-death struggle, such as the immune system, digestion and tissue repair systems, so these are turned off or suppressed to focus on the mission of providing more strength and speed and quicker blood flow to the arms and legs to achieve that. Driving the rush of blood is jacked-up blood pressure and a rapid heart rate.

These are all major adjustments to how our bodies operate and the equilibrium they need to function properly. With chronic stress, these and other realignments become the staging grounds for long-term damage. The effects of the increased heart rate and blood pressure alone are enough to make anyone swear off chronic stress (and, yes, we can do that by managing our reactions). They lead to the nation’s number one killer, cardiovascular disease.

The heart, arteries, and blood vessels have to work much harder under the command of the stress response, which they can manage for a while, but after a continuous period of excess emergency mode, things start breaking down.

The intense velocity of blood gushing through blood vessels like water through a fire hose starts wearing down the lining inside the vessel, causing little tears and pockets that attract a crowd—immune cells, foam cells of fatty nutrients, circulating platelets that promote clotting, fat, glucose, bad cholesterol, and plaque.

It’s standing room only inside your blood vessels and a heightened risk for clogs that restrict the flow of blood raging through veins in the form of atherosclerosis.

HEART ATTACK RISK

And that’s not the only way chronic stress alters the critical work of your circulatory system. The force of the blood flowing through veins is so great that it causes muscles to grow around them to contain the load. Those muscles, in turn, can clamp down on the vessels, making them more rigid, restricting blood flow and increasing blood pressure further.

Chronically increased blood pressure leads to hypertension and a host of issues that come from it, including heart attacks. Forcing the heart to pump faster and harder than it’s supposed to beefs up the muscle on the left side of the heart wall, leading to left ventricular hypertrophy, which is the top tipoff of cardiac risk.

Meanwhile, over in the abdomen department, chronic stress is mucking up your body’s digestion equipment by putting the system on idle. It forces the stomach to cut down on acid secretion, and bicarbonate and mucous production, which help protect the stomach. These and other changes left to fester from ongoing stress can lead to gastritis, acid rebound, ulcers when combined with the Helicobacter pylori microbe, and irritable bowel disease.

SUPPRESSED IMMUNE SYSTEM

The need to keep the immune system functioning well is a pretty simple concept to grasp. Without our built-in defenses keeping at bay a world buzzing with bacteria, microbes, parasites, and viruses, we are more apt to come down with any number of health problems. Long-term interruption of the immune system from stress causes a 40% to 70% reduction in the various metrics of the immune system function.

Stress releases a flood of glucocorticoids, such as cortisol and other steroid hormones into the bloodstream. They have been shown to interfere with the body’s immune agents, such as lymphocyte cells, sidelining some, disappearing others inside immune cells, and even killing lymphocytes.

As University of California at Berkeley’s Robert Sapolsky detailed in his fabulous book, Why Zebras Don’t Get Ulcers, “Give someone massive amounts of glucocorticoids, or a huge stressor that has gone on for many hours, and the hormones will be killing lymphocytes indiscriminately, just mowing them down. Have a subtle rise in glucocorticoid levels for a short time…and the hormones kill only a particular subset of lymphocytes—older ones, ones that don’t work as well.”

Clearly, then, the smart thing to do is to stop ignoring stress, or sucking it up, as we are told we have to do. When we don’t challenge stress and turn off its false danger signal, we think about it. It’s this rumination, the circular cogitating over the exaggerated belief kicked up by an ancient brain that doesn’t get the modern world that drives stress—and chronic ailments and diseases that come from it. It’s the story we tell ourselves about the stressful event that causes stress, not the external event.

CATCH YOURSELF IN THE REACTION ACT

This is something we can change by cutting off the stress spiral as soon as possible after the stress response is triggered. The longer the irrational emotions from our primitive limbic system are allowed to fan the false belief of stress (always false unless it’s a real life-or-death event for you), the more the bogus belief is entrenched as real. And off we go for who knows how long with the cumulative damage to our cardiovascular system, digestion, and immune systems, among many other impacts.

We have to become adept at catching ourselves when we go off on emotional reactions. When someone or something pushes your buttons, use the wave of white-hot emotion—rage, anger, embarrassment—set off by the demand or pressure as the clue that you have to not grab those emotions and the catastrophic thought/belief fanning it in your brain.

Notice it, take a series of deep breaths, and analyze the category of stress that has been set off—ego hit, unfairness, overload, or any other impetus. Having to categorize it starts the process of waking up your analytical, modern brain, which can then retake command of faculties from the ancient hijacker.

Next, identify the false story behind the stressor. What is the extreme belief behind it? How useful is this thought? What’s behind this stressor that is setting off the emotions? What’s behind that? What’s behind that? Keep going until you find that the bottom-line cause is not a life-or-death emergency.

Tell yourself you can handle it, because you always do handle it. You may not know how at this moment, but you will, just like every other time you rose to the occasion. With that, you have cut off the destructive wrecking ball of chronic stress before it can spiral into a multi-day/week/month/year destruction derby of life-changing medical conditions.

If you would like to learn more about how to beat the default stress reflex in your organization or individually, click the button below for details on my stress management trainings and keynotes or here for stress management coaching for individuals.

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Tags: stress reduction techniques, chronic stress symptoms, risks of chronic stress

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