by Christopher Bergland
Anger, anxiety, and depression can trigger inflammation linked to heart disease. We all know from life experience that negative emotions like stress, anxiety, fear, depression, and anger each have tell-tale bodily warning signs attached to them. Recently, researchers have discovered that there is a strong link between negative emotional states, brain circuitry, inflammation, and an increased risk of heart disease. Heart disease is the leading cause of death in the United States. Scientists at the University of Pittsburgh have found that how well someone responds to negative emotions is linked to his or her risk of having a heart attack or stroke. This study offers new clues for psychological interventions that could reduce the risk of cardiovascular disease. The May 2014 study (link is external) titled “An Inflammatory Pathway Links Atherosclerotic Cardiovascular Disease Risk to Neural Activity Evoked by the Cognitive Regulation of Emotion” was published by Elsevier in the journal Biological Psychiatry. Dr. Peter Gianaros, first author of the study, is an Associate Professor with the Biological and Health as well as Clinical Psychology programs in the Department of Psychology at the University of Pittsburgh. Gianaros is doing cutting edge research on the mind-body connection and how physical well-being is linked to psychological and social factors. Gianaros research uses a combination of psycho-physiological methods combined with brain imaging to identify the neural correlations to cardiovascular stress reactions during times of anxiety, depression, anger, etc. In this study Dr. Gianaros wanted to explore the neural responses triggered by psychological stress and emotion regulation to predict current levels of preclinical atherosclerosis. Stroke and heart attacks are the result of progressive damage to bloodvessels via a process called atherosclerosis. What is Atherosclerosis? Atherosclerosis also known as "hardening of the arteries" is a disease in which plaque builds up inside your arteries. Over time, this plaque hardens and narrows your arteries which reduces the flow of blood and can lead to serious problems, including heart attack, stroke, and death. Atherosclerosis progresses more quickly when there are high levels of “pro-inflammatory cytokines” like interleukin-6 in the body. Persistant negative emotions are believed to increase the risk for atherosclerosis and cardiovascular disease by raising the levels of inflammatory causing chemicals in the body. In future studies, the researchers at University of Pittsburgh hope to identify the specific neural circuitry underlying this process. Peter Gianaros has a hunch that the same brain areas involved in emotions are also involved in sensing and regulating levels of inflammation in the body. The hypothesis is that brain activity linked to negative emotions—and the psychological ability to regulate negative emotions—is related to atherosclerosis and an increased risk of cardiovascular disease. Interleukin-6 Can Trigger Systemic Inflammation To conduct the study, Gianaros and his colleagues recruited 157 healthy adult volunteers who were asked to regulate their emotional reactions to unpleasant pictures while their neural activity was measured with functional brain imaging. The researchers also used a non-invasive method to scan their arteries for signs of atherosclerosis and assess heart disease risk and measured levels of inflammation in the bloodstream. Individuals who showed the most robust brain activity when regulating their negative emotions also exhibited higher levels of interleukin-6. Interleukin-6 is a cytokine that triggers inflammation and leads to increased thickness of the carotid artery wall, a marker of atherosclerosis. The inflammation levels seen across the board paralleled signs of atherosclerosis along with more brain activity during emotion regulation. Gianaros believes that these findings show that the same brain regions used to regulate emotions also regulate inflammatory responses.
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by Saima Husain, MD
Stress can either be mental or physical. Mental stress, the type we address in this article, is a situation perceived as an uncontrollable threat to an individual’s well-being. Our responses to stress have evolved because it is critical to survival in a dangerous and hostile environment. These responses prepare one for either fight or flight. So how does stress affect the cardiovascular system? Mental stress is a risk factor for cardiovascular disease, or CVD, according to both experimental and clinical evidence. Mental stress may cause:
These findings suggest that mental stress may trigger the clinical events of coronary heart disease, particularly in the presence of advanced hardening of the coronary or heart arteries also known as coronary atherosclerosis. Role of Stress in Diabetes and High Blood Pressure The effect of mental stress on increased glucose intolerance or insulin insensitivity can lead to diabetes. Diabetes raises the risk of coronary heart disease; and the excess risk associated with mental stress may be, in part, made worse by diabetes. However, there are few medical studies that actually examine how much mental stress contributes to mortality as well as the occurrence of CVD. One of the potential reasons for the excess risk of heart attack associated with mental stress is the effect this stress has on increased blood pressure levels and heart rates by increasing the body’s fight or flight activities. People who experience more elevated blood pressure response to mental stress tend to live with more atherosclerosis in the arteries that supply the heart with oxygen and nutrients it needs to pump. Studies show that these patients continue to experience ongoing hardening of these arteries. Stress can raise blood pressure both immediately and chronically. Immediate stress, which is often called acute stress, is the tension one feels during an episode of fear or anxiety. Acute stress can cause a rapid and large increase in blood pressure and heart rate. But, it is usually short-lived. Patients who already have high blood pressure, often complain of symptoms such as dizziness, palpitations, and headache, which are also caused by anxiety. Panic attacks are common in the general population, but are more frequently seen in individuals with high blood pressure. The role of chronic stress in contributing to high blood pressure is less clear partly because chronic stress is so hard to measure. The perception of stress is largely subjective and experiences that may be stressful for one person may be much less so for another. There is consistent evidence that “stressed” people in impoverished environments, or those who move from a traditional structured environment to a less secure urban lifestyle, are likely to show an increase in blood pressure. Personality factors such as time urgency and hostility may also be important. After the terrorist attacks of September 11, 2001, there was evidence of a nationwide increase in blood pressure (of approximately two mm Hg) during the month after the attack. One of the best-studied models of chronic mental stress is exposure to job strain, defined by a combination of high demands and low control at work. Men who work in high-strain jobs have elevated blood pressure not only at work but also during sleep, suggesting that chronic stress can reset our blood pressure to a higher level. Women are less susceptible to this effect. |
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