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

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