During These Times Of Economic Crisis A Cardiologist Warns Against Signs Of A Cardiac Crash

Main Category: Cardiovascular / Cardiology
Also Included In: Anxiety / Stress;  Psychology / Psychiatry;  Mental Health
Article Date: 09 Oct 2008 - 5:00 PDT

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Rising unemployment rates, the worst Wall Street crises since the end of World War II, record home foreclosures. There is plenty of stress to go around. What effect is stress having on our health and what can we do about it?

"Prolonged stress, both emotional and physical, impacts the overall cardiovascular status of our patients, particularly their blood pressure," said Keith Churchwell, M.D., executive medical director of the Vanderbilt Heart and Vascular Institute.

American and global stock markets on a daily rollercoaster ride, anxiety over the burden of the government's bailout of Wall Street, and the added stress placed on all Americans by increased financial instability could be taking its toll.

Stress can cause increasing physical demands on the body, constriction of the coronary blood vessels and heightened electrical instability in the heart.

Emotional stress can lead to decreased heart rate variability and elevated blood pressure, making the heart work harder by putting even greater stress on the whole cardiovascular system. The long-term elevation of blood pressure can have a harmful effect on the heart and the entire vascular system. Stress hormones called catecholamines, including adrenaline, can have damaging effects on the heart muscle if exposed to elevated levels for a long time, Churchwell said.

A study of more than 10,300 civil servants found that employees under 50 who suffered chronic stress had a 68 percent higher risk of heart disease than those who were not stressed at work. The findings were reported in the European Heart Journal in January by researchers from University College in London.

This study demonstrates that stress at work can lead to coronary heart disease through direct activation of neuroendocrine stress pathways and indirectly through health behaviors, according to the report.

"It's almost always multifactorial," Churchwell said. "It's not just the stress, but also how people adapt to stress."

Many people react to stress by eating poorly, stopping exercise, smoking, drinking and missing medications.

If someone comes in to the Emergency Department complaining of chest pain, doctors will ask about emotional related stress, in addition to performing a medical evaluation to find the cause of the chest pain.

"We will see a number of people come through the Vanderbilt Heart and Vascular Clinic for an evaluation of chest pain, elevated blood pressure, and shortness of breath that are outward manifestations of the emotional currents going on in their work lives," Churchwell said. "They will either be dragged in by a family member who is worried about them or by a co-worker."

Churchwell added that he has not seen anyone whose heart troubles are caused by the recent stock market problems, but he wouldn't rule it out as a possibility.

"We do see stress-related chest pain in people affiliated with the music business. They have been on the road doing 50 shows in 52 nights. They call from the road and ask if they can be seen this week, and they pull the tour bus up in front of the hospital."

Churchwell offers these tips to avoid letting stress get the better of you:

- If you have a positive routine in terms of stress relief, such as exercise, stay on it.
- If you have to work 12-14 hours a day, take the time to eat healthy. Avoid junk food.
- Continue to take your medications as prescribed.
- Don't resort to smoking and drinking alcohol as "stress relievers."
- If you experience chest pain, seek the care of a health care professional.

Vanderbilt University Medical Center