Lower stress to prevent heart disease

Why is it important to lower my stress level?

Stress is the way we all react to change. It includes our mental, emotional, and physical responses to the pressures of everyday life. Change is a natural and normal part of life, and therefore a moderate amount of stress is part of normal living. However, how we choose to control and manage our stress determines whether it has a positive or negative effect on us.

Stress can be short-term (acute) or long-term (chronic). Acute stress is a "fight-or-flight" reaction to an immediate threat. Triggers of acute stress include crowds, noise, and dangerous situations. Chronic stress requires you to suppress your natural "fight-or-flight" reaction over hours, days, or even years. Chronic stress triggers include demanding jobs, family problems, marital problems, money worries, or feelings of inadequacy or loneliness.

How your body reacts to acute stress

• Your brain sends out various hormones, including cortisol and adrenaline.
• Your immune system prepares for attack.
• Your heart, lungs, and circulatory system kick into high gear:
  • Your heart rate and blood pressure increase.
  • Your breathing becomes more rapid and your lungs take in more oxygen.
  • Your blood flow increases 300% to 400% to get your muscles, lungs, and brain ready for any added demands.
  • Your spleen releases more red blood cells so that your blood can carry more oxygen.

Stress can be both good and bad

The acute stress reaction is important to protect your body and improve your performance. For example, your stress reaction helps you manoeuvre through a dangerous traffic situation or play well in the championship game. However, chronic stress can have a harmful effect on your body.

The parts of your body that react to stress can become chronically over- or underactivated, leading to physical or psychological damage. Circumstances that can cause such damage include:

• More than one stressful situation in your life at one time, such as a demanding job plus family problems.
• Stress caused by a traumatic event (such as a death in your family) that does not subside.
• Any kind of stress if you have a heart condition.

Physical damage caused by stress

Stress can negatively affect your heart in many ways.

Stress and the heart

What stress does	Why it's bad for your heart
Can narrow your arteries	Could reduce blood flow through your coronary arteries, which could cause angina or a heart attack
Increases your blood pressure	Could increase the workload on your heart and rupture a plaque in your coronary artery, causing a heart attack
Increases your heart rate	Could cause a potentially dangerous irregular heartbeat (arrhythmia); increases your heart's workload

Stress may also cause or worsen sleep, concentration, stomach problems, headaches, and back and neck pain.

Psychological damage caused by stress

Stress is associated with depression and anxiety disorders and can reduce the amount of pleasure you get out of life. Chronic stress can numb you to feelings of satisfaction and accomplishment. Eventually, this numbness could have a negative impact on your work and your relationships.

People suffering from stress sometimes turn to unhealthy habits to deal with their stress. For instance, many people eat when they are stressed out, which can mean that they eat too much or eat unhealthy foods. Some people react to stress by leading sedentary lifestyles or doing passive activities, such as watching television. Other people abuse caffeine, tobacco, alcohol, or illegal drugs to escape their stress. All of these methods of dealing with chronic stress are extremely unhealthy and can cause serious health problems, which may lead to even further stress.

You may be feeling stress if you have one or more of the following symptoms.

Symptoms of stress

Physical symptoms Headaches Heartburn Muscle tension High blood pressure Rapid heartbeat Changes in bowel movements Weight gain or loss Cold hands and feet

Psychological symptoms Irritability Preoccupation Depression or anxiety Crying for no reason Feeling useless Nightmares

Behavioural symptoms Sleep problems Confusion or trouble concentrating Decreased productivity Aggressive behaviour Talking too fast Abuse of drugs, alcohol, sex, or gambling

How can I lower my stress level?

Luckily, there are several steps you can take to help reduce your stress level. Doing so will have a positive impact on your health and your life.

No single method of "stress-busting" works for everybody. You may need to experiment with several different methods to find one that works for you. You may need to combine a few methods to get the best results.

Once you find one or more methods that work for you, your mission is not yet accomplished. You also will need to change the situation that is causing you stress, if you can, or perhaps change your reaction to that situation.

Cognitive-behavioural methods can be the best way to lower your stress level.

• Identify your stress triggers. You may want to keep a journal to record them. For example, does running late make you stressed? Or is it feeling like no one listens to you at work? Bouncing a check? Coming home to a messy house? Once you identify your stress triggers, you will be able to plan for them.
• You should also recognize activities that have a positive effect on your stress level, such as meeting a deadline, riding your bike, or reading before going to bed.

Think of solutions for dealing with your stress triggers. These solutions include both ways to prevent stressful situations from happening as well as alternative reactions to them.

Add stress-busting activities to your day

You need to shift your focus onto stress-reducing activities as opposed to stress-producing activities. One study about stress showed that adding enjoyable activities to your day can help you even more than eliminating or dealing with your stress triggers. Even small changes can have big effects on your stress level.

Set aside some time for yourself each day to do something you find relaxing. The more of these types of activities you work into your daily life, the more your stress level is likely to improve. The following are examples of stress-reducing, enjoyable activities.

• Stay connected to your family, friends, and other supportive people in your life.
  • Talk about your problems and your feelings. When you don't express feelings of anger or frustration, it can lead to a sense of helplessness, depression, and even hostility.
  • Join a support group in your community to share your feelings.
• Exercise. Exercise is one of the best ways of distracting yourself from your stress triggers. It can help you clear your mind and work off anger and frustration. Also, exercise has many other great benefits, such as:
  • Lowering your blood pressure.
  • Contributing to weight loss.
  • Improving your cardiovascular health.
• Try deep breathing, meditation, or yoga. These techniques can help quiet your mind and counteract your body's physical stress reactions. You can check local fitness centres and community centres for classes or instructors.

Other tips for managing stress

• Keep your perspective. Take a moment to think about what's bothering you. Ask yourself, "Is this really that important?" or "Is it reasonable to become so stressed out about this?" You'll find that the answer is usually "no."
• Identify which of your stress triggers are within your control and which are beyond your control.
• Keep a sense of humour about life. If you can laugh and look on the bright side of a stressful situation, you can affect your stress level. Your body and mind both will be calmed by even a chuckle.
• Seek help if you feel overwhelmed. Psychiatrists, psychologists, social workers, counsellors, and many other mental health professionals are trained to help people deal with problems in their lives. If you feel that you cannot effectively deal with your stress by yourself, find a professional to help. Ask your doctor, friends, and family for references, or check your phone book for a listing of professionals in your area.

For more information, see the topic Stress Management.

Also see information on:

• Guided imagery.
• Humour therapy.
• Biofeedback.
• Massage.
• Yoga.
• Tai chi.

Author:	Douglas Dana Robin Parks, MS	Last Updated November 13, 2006
Medical Review:	Adam Husney, MD - Family Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology Linda F. Hellstedt, MSN, RN - Cardiac Nursing Robert A. Kloner, MD, PhD - Cardiology Ruth Schneider, MPH, RD - Diet and Nutrition
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