Cardiovascular Health and Lifestyle medicine🌿 Part 6- Stress 🐯 & social connection 🤝🏼

 

Stress 🙃 

It is hard to imagine how you could go through a day without any stress🤷🏽. Although small amounts of stress are less harmful, its effect changes when it becomes chronic. Stress is a reaction when a threat takes place within our body and leads to a release of cortisol and catecholamines into our system. This cascade of endocrine function influence can lead to sympathetic nervous system involvement. Stress can be helpful in our life, to help protect us. If an animal 🐯 jumps out in front of us it can set our fight flight response off, so we can deal with the possible danger. But if this system is overactive, the stress becomes chronic, then that can become a problem… 

There is a particular condition called ischemia, where tissues in the body are deprived of oxygen, which is crucial for human life. Where mental health is concerned, it can lead to the presence of ischemia in the heart for up to 30-60% of people. If this ischemia is present in our heart and surrounding tissues, it can be very dangerous. Even acute stress from being at a football game or losing someone you love can place enormous ischemic loads on the heart, especially in the presence of Cardiovascular Disease CVD. 

Chronic work stress and COVID-19 related stress are significant examples of chronic stress risk. Anger 😡can not only be a trigger for acute coronary events, but CVD risk is exacerbated when hostility or anger is part of a person’s behavioral traits. 

Stress can have a significantly negative effect on our cardiovascular (CV) health. It has been shown to increase some CV risk by up to 63%, examples such as divorce can have a negative impact. However, being married has a positive effect on our CV health in close relationships. 

Anyone suffering from Post traumatic stress disorder (PTSD) can have a 50% increase in CVD risk and has a confounding effect if there is already CVD present, possibly twice the risk of CV events taking place. Other risks such as Hypertension, obesity and Diabetes are all more likely to develop for those suffering with PTSD, as often activity and social integration levels are more likely to be lower. We commonly associate PTSD with military personnel returning from operations in combat zones, but there are more people with PTSD in the community that are not military 👮🏼‍♀️ personnel. 

Some of the risks to our CV system can include: 

·       Our blood pressure rising

·       Development of Atherosclerotic plaques (with stenosis or narrowing of internal blood vessel)

·       Vasospastic disturbance, leading to chronic vasoconstriction in blood vessels, leading to systemic vascular resistance

·       Inflammatory and immune system dysregulation

·       Arrhythmias (electrical instability in the heart)

·       Risk of heart attack

·       Risk of stroke 

I take this opportunity to point out the gains you can make using the wide portfolio of Lifestyle medicine pillars to reduce CVD and CV events taking place. Diet🍲, activity🚶🏽 and exercise, cessation of smoking⛔️, alcohol 🍷moderation, sleep 💤quality and avoidance of environmental influences 🤼 all have their effect on stress levels. A portfolio approach to Lifestyle medicine care is therefore crucial. Working on at least 3 of these pillars is beneficial for CVD prevention, but why stop at 3?  With all these together you can prevent up to 80% of cardiovascular disease, and in some cases reverse your CVD. (I.e.: reduction of stenosis, caused by atherosclerotic plaque production). More intense intervention is highly recommended, for example where there is a presence of CVD or diabetes. 

Some recommendations for keeping stress levels down include, but not limited to: 

•   Getting aerobic exercise by going out for walks, swim or bike riding, and making sure you are meeting the minimum requirements set out by your national heart association for exercise. This will help you to sleep better too, which helps reduce stress levels.

•   Being careful not to be overcommitted with responsibilities.

•   If you are a caregiver, make sure you find some time for self-compassion 🫶🏼, this may include respite/carer services and support.

•   Doing some mindfulness-based mediation 🧘🏼‍♂️practice, group meditation or prayer groups.

•   Seeking professional help, such as a psychologist, counsellor or family doctor 🧑‍⚕️.

•   Yoga 🧘‍♀️ practice, Tai chi, gratitude journals. 

Remember stress can coexist with anxiety or depression, and anxiety can be present with depression. In summary, cardiovascular disease risk needs to be managed with a focus on our mental health, as the unification of good CV health prevention portfolios cannot exclude mental health. We all deserve to be happy😇. 

 

Social connection 

For too long in the western world the spiritual aspect of health has been ignored. Yet the single most vital determinant for longevity 🧧has been shown to be social connection☯. When 268 graduates from Harvard University were studied 🔬 over an 80-year period, the key indicator for both happiness and longevity were linked to how happy our relationships are. This study started in 1938. This research clearly pointed out the necessity for us to develop our relationships with people in our lives. Social contact can reduce the likelihood of becoming more stressed. 

Even the value of micro moments of contact with other people has been shown to be valuable. As the quality of our relationships is so important, finding an individual prescription for ourselves can make a big difference in our CV health and the length of our life. Even if you feel your social contact is satisfactory, some of the following suggestions may be of interest: 

·       Joining a music 🎼 society or book 📖 club

·       Contacting that friend that you have been meaning to catch up with for a long time

·       Joining a dance 🕺🏽 group to learn some new moves

·       Becoming a volunteer for a group or hospital you may like to support

·       Joining a sporting ⛹️‍♂️ group or walking 🚶🏽club

·       Arranging a family event 🎉, and then taking it in turns to continue the contact 🎭 

Although social media can be an attractive option, it is not the same as being in physical contact with other people. In summary, see your social connection opportunities as a wise investment into improving your mental health. We all have a degree of stress in our lives. Even toddlers from age 2 upward can start exhibiting the start of atherosclerosis, as the lifestyle factors that affect adult development of CVD are the same for them. (In fact, even observed in utero in some cases where hypercholesterolemia was presenting in the mother).  Helping us control our stress levels and increase our social interaction opportunities will decrease the risk of CVD and multiply the risk reduction when the full portfolio of lifestyle medicine pillars is included. 

Have a lovely day and see you next week!

 

P.S. next week I will start a new topic of blogs on Weight Control ⚖️, which you will find it under www.talkingweightcontrol.blogspot.com Lots of my followers have been waiting for it for a very long time, I believe after all the knowledges you learnt from my talkinglifestylemedicine blogs, it is a time for us to dig deeper into one of most important topics – Weight Control, see you there!

 

References 

Mineo, Liz; Good genes are nice, but joy is better.The Harvard Gazette. News.harvard.edu; 5.6.22, 2.02pm. 

Kelly, J et al, Foundations of Lifestyle Medicine. The Lifestyle Medicine Board review manual.  American College of Lifestyle Medicine. Copyright 2021. p. 321-334 

Marc de Hert,Johan Detraux and Davey VanCampfort (2018) The intriguing relationship between coronary heart disease and mental disorders. Dialogues in clinical Neuroscience, 20:1, 31-40, DOI: 10:31887/DCNS.2018.20.1/medhert 

Rippe, James M, Integrating Lifestyle Medicine in Cardiovascular health and disease prevention. P95-103. Copyright 2023, Taylor and Francis group. 

Wilson, Don P, MD, FNLA. Is Atherosclerosis a paediatric disease> National library of mMedicine, NCBI.nml.nih.gov, 5.6.23, 2.28pm.