Heart 411

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Can Stress Trigger a Heart Attack?

This question pertains to people who already have coronary heart disease and blockages in the heart’s arteries. The short answer is this: Emotional stress can trigger a heart attack in a person who has coronary heart disease. A variety of “accidental” experiments confirm this finding.

On January 17, 1994, the Northridge earthquake devastated parts of southern California. That day, the number of deaths from coronary heart disease in Los Angeles County nearly doubled. The greatest death toll was recorded closest to the epicenter of the earthquake, with the number of patients dying from heart attacks decreasing in proportion to distance from the epicenter. Interestingly, in the weeks following the earthquake, the number of people dying from heart attacks was unusually low, in part because many of the most vulnerable people had already died.

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More recently, Hurricane Katrina endangered the heart health of New Orleans residents. This natural disaster has had a long-term impact. Years after the storm, New Orleans residents still face an increased risk in heart attack.

Man-made disasters also endanger heart patients. At the beginning of the first Gulf War, Israeli citizens were under constant and enormous stress, wearing gas masks and continually running for safety as Scud missiles rained down on Tel Aviv. The first days of the war saw a dramatic increase in heart attack admissions to local hospitals. As in the case of the Northridge earthquake, this rate decreased after a few days—the war continued, but the most vulnerable patients had had their heart attacks in the initial days of the fighting. In addition, people eventually became somewhat accustomed to the constant sounds of sirens and the stresses of war.

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For Americans, the stress associated with the terrorist attacks of September 11, 2001, was qualitatively different from the stress experienced by communities during earthquakes and rocket attacks. As a result of widespread media coverage, the entire country was affected. Heart attacks and abnormal heart rhythms spanned the country and were recorded from New York to Miami to Los Angeles.

What about “everyday stresses?” The effects are similar. Three percent of heart attacks are triggered by anger. Divorced and single people are more likely to succumb to heart disease than are the happily married. And a recent study from Duke University shows that heart health tracks the stock market; when the market goes down, heart attack risk goes up.

What Can You Do?

Fortunately, major disasters like earthquakes and terrorist attacks are relatively uncommon. But life’s “regular” stresses—money, marriage and relationships, work—are daily occurrences. How can you manage these everyday stressors to help yourself feel better and, at the same time, protect your heart?

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The National Institutes of Health and other funding agencies have become increasingly involved in supporting studies designed to answer this important question.

Preliminary results support the notion that a variety of strategies can reduce stress and improve heart health. Scientists have achieved positive results with yoga, biofeedback, guided imagery, cognitive behavioral therapy and even transcendental meditation.

But our favorite stress reliever is exercise.

Exercise is an extremely effective tool for stress management. A good workout requires focus and concentration, freeing your mind from turmoil. As you concentrate on your running stride or your tennis backhand, thoughts of that problem at work or dip in your finances leave your mind.

Meanwhile, your heart “enjoys” the proven cardiovascular benefits of exercise, including reduced blood pressure, improved fitness, weight control and reduced risk of diabetes.

It is impossible to avoid all of the stresses of modern life. But you can manage your stress. Don’t succumb to temptation and reach for the Haagen-Dazs when you feel frustrated, angry or stressed.

Instead, lace up your running shoes or dig that racket out of the closet. You’ll feel better and you’ll do your heart a favor.