An important diversion today away from the fun and frolics of mainstream entertainment. Here we explore the serious matter of lifestyle choices, their effects on stress and the impact of stress on the risk of heart disease.
For many years scientific evidence has tried to link stress and heart attacks — but it has come to light that not just stressed middle-aged executives are at risk from heart disease.
You could be forgiven for experiencing a sense of déjà vu when reading yesterday’s news that researchers have identified a link between stress and heart attack. After all, when asked to think of a heart attack victim, most of us revert to the stereotype of a sweating, stressed-out middle-aged businessman clutching his chest. However, the link with stress has never been that clear cut.
According to the British Heart Foundation there is no convincing evidence that stress is a direct causal factor for heart disease. Indeed, the Harvard study behind yesterday’s headlines — showing that stress exacerbates narrowing of the coronary arteries, increasing the risk of blockage — only identified a possible mechanism. It did not confirm that the stressed individuals went on to have more heart attacks, only potentially deleterious changes in their circulation.
Although there may not be much evidence of a direct link between stress and heart attack, there are plenty of indirect associations to explain why the relationship is so established in medical lore. Stress induces a range of physiological changes, such as raising blood pressure, that do have direct associations with premature ageing of the coronary arteries and increase demand on the heart. And stressed individuals also tend to lead unhealthier lifestyles. They may drink or smoke more, not sleep as well, have less time or inclination to eat healthily, and visits to the gym are one of the first things to be dropped when under the cosh at work.
The fact that our middle-aged businessman is stressed, though, isn’t the only problem with the stereotype. While work-related problems are the number one stressor in western society, it’s those lower down in organisations who are most likely to develop heart disease — not so much your high-flying company executive as the man on the factory floor. And you don’t have to be a male, or that old either.
Over the next 12 months at least 6,000 people in the UK between the ages of 35 and 60 will die from heart disease; and while men account for the majority, women are far from immune. The average British woman is three times more likely to die from a heart attack than she is from breast cancer, yet she is far more likely to check her breasts than worry about her blood pressure or cholesterol.
Fortunately we are winning the war against heart disease. In the Sixties it killed nearly 200,000 British men and women every year. Today that figure has more than halved to about 80,000 a year thanks to medical advances and improvements in lifestyle and standards of living. Heart attacks, though, still remain an all too common threat — about half of all 40-year-old men and a third of women will go on to have a heart attack at some stage of their lives — and effective prevention is key.
Stress is hard to tackle. If problems at work or home were easy to deal with they wouldn’t be stressful. Yet there is plenty you can do to negate more established direct risk factors such as diet, lifestyle and high blood pressure — and the more likely you are to run into trouble, the greater the benefits.
The simplest way to identify whether you are heading for an early grave is to use one of the risk calculators that GPs and cardiologists depend upon to assess their patients. The latest version is now available as an app for your smartphone and, for the first time, estimates your “heart age” so that you can see how you are faring compared to your peers.
You can also keep an eye on your blood pressure by using one of the many types of monitors available for home use as suggested by the National Instute for Clinical Excellence in this feature on the Encyclopedia Britannica
Rapid assessment in the event of trouble is also vital. Dial 999 if you develop symptoms suggestive of a heart attack — typically central chest pain, often described as heaviness, which lasts ten minutes or more and may spread to the neck, jaw or arms. Time is of the essence; the quicker you get to hospital, the more likely you are to benefit from the latest treatments and make a full recovery.
Don’t delay just because you think it can’t happen to you. It can.
The new Heart Risk app, launched earlier this month, is designed to help doctors identify their patients at higher than average risk of stroke or heart attack. Visit jbs3risk.com for more details.
The free app is based on a number of criteria including age, history, blood pressure, height, weight and cholesterol level, and contains a number of new features including a prediction as to how long it will be before you are likely to have your first heart attack or stroke. You can also change relative criteria (such as whether you smoke or not) to see how it impacts on your overall risk.