How mental stress can break your heart
image: Some plaques do not progress (control group), while some do not progress for a period and then suddenly and rapidly progress in size (type 1 progression). Others grow and progress gradually (type 2 progression).
Credit: Hean Teik Ong, Jinghong Chen.
A review published in General Psychiatry explores the connection between mental stress and cardiovascular events, highlighting inflammation as the key link. The study, led by Dr. Hean Teik Ong from University Tunku Abdul Rahman, Malaysia, and Prof. Jinghong Chen from Shanghai Mental Health Center, synthesizes observational and experimental data to review how mental stress can lead to adverse cardiovascular outcomes.
The review cites several observational studies demonstrating that mental stress significantly increases the risk of cardiovascular events. For instance, a Norwegian study found that individuals with health anxiety had a 2.12 times higher risk of developing ischemic heart disease compared to those without such anxiety.
The study emphasizes that mental stress leads to systemic inflammation, which can cause rapid plaque progression and thrombosis, leading to type 1 myocardial infarction (MI). Inflammation can also lead to type 2 MI or direct myocardial injury, as seen in conditions like Takotsubo cardiomyopathy (or, broken heart syndrome), often triggered by stressful events.
Experimental studies have shown that mental stress-induced myocardial ischemia (MSIMI) is prevalent among patients with coronary artery disease. One meta-analysis found that MSIMI increased the risk of subsequent cardiac events or mortality by 2.2 times.
Also, elevated levels of inflammatory markers have been observed in both cardiovascular and mental health conditions, further supporting the link between mental stress and cardiovascular events.
The review highlights the potential value of anti-inflammatory drugs in managing both cardiovascular and mental health conditions. For instance, trials with colchicine have shown promising results in reducing adverse cardiovascular events in patients with recent MI and stable coronary disease.
Prof. Jinghong Chen, one of the authors from Shanghai Mental Center, emphasized, "Recognizing the link between mental stress, inflammation, and cardiovascular events can help clinicians manage these comorbidities more holistically."
The study underscores the importance of addressing mental stress as a significant risk factor for cardiovascular diseases. By understanding the role of inflammation, healthcare providers can adopt a more integrated approach to managing these conditions, potentially improving patient outcomes and quality of life.