Stress is a woven thread in the fabric of our lives, a touch of it nearly inevitable. Today, let's explore how stress shapes our well-being, with a focus on its impact on the heart.

Medical inquiry into "stress" has honed in on "job stress," characterized by demanding work settings with low control and limited social support. Another lens reveals "caregiver stress," stemming from tending to a loved one grappling with chronic illness like dementia. Lastly, the strain of social isolation and loneliness casts its shadow, increasingly affecting both the young and the elderly in our modern society.

The exposure to stress triggers a region of our brain known as the hypothalamus, prompting the release of stress hormones and the activation of the "fight or flight response." This cascade reverberates through various organs, including our nervous system, metabolism, and heart.

Long-standing, low-level stress is suspected to elevate blood pressure, disrupt insulin's efficacy, increase clotting, and destabilize the lining of our blood vessels. The body of research surrounding chronic stress suggests an elevated risk of heart disease, ranging between 40% to 60%, compared to those untouched by stress.

In the face of chronic stress, unhealthy habits like smoking, excessive alcohol consumption, and physical inactivity may resurface. Prolonged work hours, particularly exceeding 11 hours a day, coincide with shortened sleep duration and heightened sleep disturbances.

Acute stress can trigger heart attacks, strokes, or even sudden cardiac death. A pivotal study emerged after a significant earthquake struck Athens in 1981, revealing a surge in cardiac deaths over the following three days. Other calamities, such as industrial accidents, wars, and terrorist incidents, have also been correlated with an uptick in cardiac fatalities in their aftermath. Intriguingly, stress-induced heart attacks, characterized by arterial spasms rather than blockages, are more prevalent in women. A fascinating study by Witte et al. showcased a 51% spike in heart attack or stroke mortality among Dutch men aged 45 and above on the day their national soccer team suffered a poignant defeat against the French during the 1996 European Cup. No corresponding increase was evident among women. A subsequent analysis in Munich documented a surge in cardiac emergencies on days when Germany played in the 2006 World Cup (2.66 times higher than on other days).

Stress and a dearth of social support can hinder recovery and rehabilitation for survivors of acute heart attacks and strokes.

So, what steps can be taken?

The initial stride involves recognizing that, alongside other risk factors, stress exerts a pivotal influence on our health trajectory.

While eradicating stress entirely may elude us, avenues to alleviate it do exist.

Engaging in exercise, nurturing social connections, prioritizing restorative sleep, embracing a balanced diet, and cultivating hobbies outside of work can all contribute to stress reduction.

Social support and personality attributes like optimism and adaptability in facing challenges can prove invaluable.

Participating in cardiac rehabilitation after a heart attack yields multifaceted benefits, psychological support being one of them.

Relaxation techniques, stress management strategies, and psychological therapy offer potential relief, though their effectiveness may vary and the necessary commitment may prove daunting.

Acknowledgment: Nature, Cardiology Review. Article authored by Steptoe and Kivimaki