Stress can crank up the risk of heart disease

trevor — Thu, 11 Oct 2007 15:32:35 GMT

By Bryant Stamford
Special to The Courier-Journal

Psychological stress is an established risk factor for heart disease. This means it contributes to clogging of the arteries along with smoking, high blood pressure, high cholesterol, diabetes, etc.

But stress has always been the Rodney Dangerfield of risk factors, getting no respect.

Much emphasis is placed on physiologic measurements, because they are easily quantified and categorized.

High blood pressure is readily identified, and treatment options are pretty straightforward. If you and I have a blood pressure of 145/95, we both, all other things being equal, would demonstrate the same degree of risk associated with such an elevated pressure.

On the other hand, if you and I are stressed, it's not so easy to quantify. What is my stress level compared to yours? Is mine higher or lower? If mine is higher, but I handle it better, am I then less stressed?

And when it comes to treatment, stress often is ignored unless it triggers physical symptoms or unacceptable behavior. And because the source of stress may be difficult to pin down, emphasis likely is placed on treating overt symptoms and helping victims cope.

Stress may be a key factor

Despite the ambiguities surrounding psychological stress, I've been saying for years that I believe it is a key factor in the development of heart disease, rather than a peripheral factor.

The analogy I have used is that stress is the blender, but it has no lid. All of the risk factors (high blood pressure, high cholesterol, etc.) are placed in the blender, creating a soupy mix.

The soupy mix can certainly be damaging to health as it sits there. But real trouble starts when the blender is turned on -- when stress increases -- spewing the soupy mix and really making a mess.

Support for this position is mounting. We know that stress can contribute to high blood pressure. Remove the stress (turn off the blender), and blood pressure drops.

Most are unaware of the effect stress has on cholesterol. The body is a cholesterol production factory, and the vast majority of cholesterol circulating in the arteries was produced in the body, in the liver. Cholesterol is an important building block in the body, and it serves as a key component for several hormones. When stress increases, cholesterol production can skyrocket. Remove the stress, and cholesterol drops.

Recent research contributes another piece of evidence indicting stress as more of a culprit. Studies in mice have shown that stress triggers release of a hormone -- neuropeptide Y (NPY) -- that promotes fat accumulation, particularly in the abdominal region.

The worst-case scenario is a high stress level combined with a lousy diet loaded with junk food. This is particularly problematic for those who over-consume comfort foods, such as chocolate chip cookies, when stressed.

Now, don't jump on NPY as a prime cause of obesity and sit around for the next decade waiting for scientists to find a way to neutralize this hormone. There are many reasons for obesity, and this is only one. But it's one that involves stress, and that's why I'm bringing it up.

Abdominal fat deadly

Fat can be added all over the body, but abdominal fat has the most severe health implications -- another cause for concern about stress and NPY. The reason is abdominal fat contributes to insulin resistance -- an inability to move glucose out of the bloodstream and into the cells where it will be metabolized to produce energy. When glucose lingers in the blood, it accumulates. A modest accumulation is referred to as pre-diabetes (also known as metabolic syndrome).

If ignored, pre-diabetes likely will develop into full-blown type 2 diabetes, a powerful risk factor for heart disease.

The bottom line

As always, my advice is the same. To beat heart disease and be healthy, eat right and get some exercise daily. Let me add that because stress may take a much larger toll than we recognize at present, put reducing stress, by whatever means possible, right up there near the top of the list.

"The Body Shop" runs Thursdays. Bryant Stamford is professor and chairman of the department of exercise science at Hanover College. If you have questions or suggestions, go to his Web site at professorstamford.com. Or address questions to "The Body Shop," The Courier-Journal, P.O. Box 740031, Louisville, KY 40201-7431.

http://www.courier-journal.com/apps/pbcs.dll/article?AID=/20071011/FEATURES03/710110319/1012

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Stress can crank up the risk of heart disease