Too much stress might result into a second heart attack, says study

Already had a heart attack and can’t keep yourself away from stress? Then you are in deep trouble dear – Because if you can’t keep stress at bay then your heart might face the brunt of it.

For those who have survived a heart attack, mental stress — and not physical stress — may be a stronger predictor of a repeat heart attack or even dying from heart disease, warn researchers.

The team at Emory University investigated whether myocardial ischemia — when blood flow to the heart is reduced such that the heart muscle doesn’t get enough oxygen — induced by mental stress was associated with poor outcomes among heart attack survivors, and how this type of stress testing compares with conventional stress brought on by exercise.

Young people are also at risk of getting a heart attack if they are stressed
Among more than 300 young and middle-aged individuals enrolled in the study, those who endured myocardial ischemia with mental stress had a two-fold higher likelihood of having another heart attack or dying from heart disease compared with those who did not have cardiac ischemia-induced by mental stress.

“In our study, myocardial ischemia provoked by mental stress was a better risk indicator than what we were able to see with conventional stress testing,” said Viola Vaccarino from Emory University’s Rollins School of Public Health in Atlanta and the study’s principal investigator.

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This is the only study of its kind in this relatively young adult population of heart attack survivors.

She added:

The investigators studied 306 adults aged 61 years or younger (50 years on average and ranging from 22-61 years), who had been in the hospital for a heart attack in the previous eight months.

Mental stress and heart-related problems go hand in hand
Traditional stress tests, in which someone exercises on a treadmill or takes a medicine that makes the heart beat faster and harder as if the person was actually exercising, have long been used to check blood flow to the heart and gauge the risk of heart problems.

Taking into account patients’ psychological stress may help clinicians better evaluate the risk of recurrent heart attacks or death seen in some patients surviving a heart attack.

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Overall, mental stress induced myocardial ischemia occurred in 16% of patients and conventional ischemia in 35%, suggesting that traditional ischemia due to exercise or drug-induced stress is more common.

Over a three-year follow-up, 10% of patients (28 individuals) had another heart attack and two died of heart-related problems.

The incidence of heart attack or cardiovascular-related death was more than doubled in patients with mental stress-induced ischemia compared with those without mental stress ischemia, occurring in 10 (20%) and 20 (8%) patients, respectively.

“Patients who developed ischemia with mental stress had more than two times the risk of having a repeat heart attack or dying from heart disease compared with those who did not develop ischemia during mental stress,” Vaccarino elaborated.

What this means is that the propensity to have a reduction in blood flow to the heart during acute psychological stress poses substantial future risk to these patients.

Such reduction in blood flow, when it occurs in real life, could trigger a heart attack or serious heart rhythm problems, she said.

Mental stress is a bigger culprit than physical stress
Another interesting finding, according to Vaccarino, is that ischemia with mental stress and with conventional stress were not strongly related to each other, suggesting that they occur through different pathways.

“This points to the fact that stress provoked by emotions has a distinct mechanism of risk for heart disease and its complications compared with physical stress,” she noted.

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How to reduce stress? Well, there are many ways and techniques that can help you deal with stressful situations. You can take up meditation. Doing cardio exercises is also a good way to de-stress yourself. Following a hobby or doing something that makes you feel happy also works well when it comes to dealing with stress. 

If nothing works out then consulting a physiologist is always recommended. So, it’s better to tame your stress level soon before it triggers your heart health.