Stress could be your heart's worst enemy

PUNE: Heart transplant surgeon Manoj Durairaj has been unable to shake off a decade-old image of a young man hooked on to life support due an unusual occurrence - a massive heart attack -- for one in his twenties. He needed an emergency angioplasty with an intra-aortic balloon pump to help his heart to function.
The patient had no underlying cause or family history, apart from stress."He eventually got better, but I was shocked to see his initial condition," said Durairaj, president of the Indian Association of Cardiovascular-Thoracic Surgeons. Ten years on, the surgeon said stress-induced cardiac ailments are more common than ever before. While healthy food, eight hours of sleep and exercise have emerged as the mantra for heart health, cardiologists say psychological stress is the major culprit.
Stress can cause an adrenaline rush, and is essential for tackling tasks requiring significant mental or physical effort. But, as Dr Anil Potdar from Fortis Hiranandani Hospital in Navi Mumbai says, "excessive stress can be harmful" as it does not allow the mind and body to relax.
"In stressful moments, blood vessels constrict, blood flow increases, and muscles tense, putting extra strain on the heart,'' said Dr Potdar. The heart requires at least seven hours of sleep to recover from this damage. In a tense situation, the adrenal glands release hormones called catecholamines that trigger the body's fight-or-flight response. These hormones can affect functioning of the heart muscles.
A study in 'JAMA Network' in Nov 2021 found an increased risk among those who had mental stress-induced ischemia. In Sept 2023, an American Heart Association study showed men who worked in stressful jobs that required high effort but gave low rewards had twice the risk of heart disease compared to those free of such stressors.
"While the immediate impact of stress is known, chronic stress can over time cause atherosclerosis and hyperglycemia that leads to binging on junk food that impacts the heart," said Dr A Sharath Reddy, an interventional cardiologist with Medicover Hospitals. Stress causes hormonal imbalance and other changes in the body. "Stress in a young woman can nullify the protection that women naturally get from estrogen or reverse its impact by over two decades when menopause hits,'' said Dr Reddy.
What is the doctor's prescription for stress? Cardiologist Dr. Tripti Deb, Consultant Cardiologist at Apollo Clinic, Hyderabad, recommends a three-pronged approach through lifestyle modifications, medications and therapy. "We recommend a heart-healthy diet, regular exercise and good sleep hygiene. Stress management techniques such as cognitive-behavioral therapy, mindfulness and relaxation exercises, can be incorporated,'' she said. Medications such as antidepressants or beta-blockers may be needed for those with anxiety issues.