Emotional Stress and Heart Disease

Emotional Stress and Heart Disease

Figure 1: Stressful life events increase the risk of heart attack and stroke.

Emotional stress and trauma have been shown to increase your risk of high blood pressure, stroke, and heart attack. Those who have had more emotionally stressful events have a higher risk of heart attack.

A new study shows how sadness in particular damages the heart.

Sadness & Inflammation

Sadness & Inflammation

Figure 1: Sadness & Inflammation. Those who feel more grief also have higher amounts of inflammatory proteins in their body. In a study of 99 volunteers who had recently lost their spouses, those who grieved more had significantly higher amounts of key inflammatory markers in their bloodstream. Both interferon gamma and IL-6 were significantly elevated in those who grieved the most compared to those who grieved less.

When we go through grief and sadness, we literally “break” our hearts. This effect is so strong that researchers were able to detect it in a blood test. With just a standard blood draw, researchers were able to find significant differences between those who are grieving more and those who are grieving less.

A new study looked deeper at the reasons behind the link between sadness and heart disease by studying 99 individuals who had lost their spouses. Presumably, these individuals would likely be going through much more “sadness” than the average person, thus heightening the effect.

Researchers split the 99 individuals into two groups, high grief and low grief, based on their responses to a grief survey.

They found that those who had relatively less grief also had lower levels of inflammatory markers in their bloodstream.

What are inflammatory markers

Inflammatory markers are proteins in your bloodstream that indicate the presence of inflammation. When you have an infection or an ongoing illness, your immune system is actively working to fight the infection. As part of the work that your immune system does, it is constantly sending out signals in order to communicate with other cells and coordinate a defensive response.

Source: Spousal bereavement is associated with more pronounced ex vivo cytokine production and lower heart rate variability: Mechanisms underlying cardiovascular risk?

Depression and Inflammation

Depression and Inflammation

Figure 2: Depression and Inflammation. Those who had more depression symptoms had significantly more inflammation in their bodies. In a study of 99 volunteers who had lost their spouse, those who exhibited more depression symptoms also had higher levels of inflammation, which has been linked to heart disease. They had higher levels of interferon gamma and interleukin-6. Of note, the p-value for interleukin 6 significant before multivariable-adjustment (not shown).

They also looked at how many depression symptoms each individual had. grief and depression are two related but distinct phenomena. It is possible to be grieving without being depressed, and to be depressed without having something specific to grieve about.

They found that depression was associated with the same changes in your body. With just a simple blood test, they could determine differences between those who were depressed and those who were not.

What is inflammation?

Inflammation is your body’s response to foreign bacteria, viruses, and other pathogens. When your immune system encounters an enemy organism it send out signals and recruits cells to fight off bacteria and other pathogens. When something is inflamed, it can appear red and swollen. It can be painful, particularly when pressed. It can feel warm to the touch.

Source: Spousal bereavement is associated with more pronounced ex vivo cytokine production and lower heart rate variability: Mechanisms underlying cardiovascular risk?

Inflammation & Heart Attacks

Inflammation & Heart Attacks

Figure 3: Inflammation & Heart Attacks. Inflammatory markers in the blood are associated with a higher risk of heart disease. Interleukin-6, which has been shown to be elevated in those who have immense sadness, has been associated with a 250% higher risk of heart disease at the higher end.

These inflammatory markers are interesting to doctors because they have been linked to heart disease, the biggest killer in the United States, as well as other conditions.

Interleukin 6, which was one of the most significantly affected inflammatory markers in the blood, has been linked in multiple studies to a higher risk of a heart attack.

Those with the highest levels of interleukin 6 had about 2.5x the risk of heart disease, including heart attacks, compared to those with low levels of interleukin 6.

Source: Interleukin 6 Inhibition and Coronary Artery Disease in a High‐Risk Population: A Prospective Community‐Based Clinical Study

Keys to Health

Bereavement and grief are a normal and unavoidable part of life. With love comes grief. No study in the world is going to be able to fix that.

What the study does provide is an insight into the mechanisms behind the link between heart health and sadness.

Inflammation is a part of your immune system, which you need to fight off infections.

However, when your body is always inflamed, this can be damaging. We’ve known that sadness can damage the heart. This study shows us how.

Sadness increases the amount of inflammation in your body. The inflammatory proteins and molecular signals flowing in your blood then in turn leads to damage in your blood vessels and heart, increasing your risk of heart disease.

Evidence Score:

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Study Type - Researchers used a cohort study to analyze the effect of sadness on inflammation. This study type is superior to a retrospective cohort, but is inferior to a clinical trial.

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Endpoints - Researchers used inflammatory biomarkers as a measurement of inflammation. This measurement allows researchers to objectively and consistently measure inflammation across all volunteers.

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Controls - Researchers split individuals into those who were grieving more and those who were grieving relatively less. This split unfortunately cannot tell us whether those who were grieving more were also more prone to stress. It cannot discern causality.

Expert Opinions

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Harvard Health Publishing

Chronic stress also is common during acute grief and can lead to a variety of physical and emotional issues, such as depression, trouble sleeping, feelings of anger and bitterness, anxiety, loss of appetite, and general aches and pains. "Men may try to resist grief, but it's important not to ignore these symptoms, as constant stress can put you at greater risk for a heart attack, stroke, and even death, especially in the first few months after losing someone," says Dr. Bui.

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Centers for Disease Control

Depression is not just having “the blues” or the emotions we feel when grieving the loss of a loved one. It is a true medical condition that is treatable, like diabetes or hypertension.

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Time Magazine

Men may be particularly likely to suffer health consequences as a result of that upheaval. A 2013 study published in the journal Economics & Human Biology found that recently widowed men had 30% higher chances of dying, relative to their normal odds of mortality. The same wasn’t true for women who lost their husbands.

Clearvue Health is not affiliated with above organizations. The information above is provided to highlight and link to useful further reading.