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Key to a healthy heart lies beyond exercise | Why managing stress, anxiety is paramount

San Diego's unique, laid-back lifestyle can be a sanctuary for many. Yet, we are not immune to stress and anxiety, America's most common mental illness.

SAN DIEGO — American Heart Month ends in February, but the focus on keeping your heart healthy certainly shouldn't.

San Diego's unique, laid-back lifestyle can be a sanctuary for many. Yet, we are not immune to stress and anxiety, America's most common mental illness affecting 40 million adults every year, according to the Anxiety & Depression Association of America.

As a licensed clinical psychologist and clinical supervisor, Dr. Maya D'eon sees how stress and anxiety play out, firsthand, at Rogers Behavioral Health in Rancho Bernardo.

"Stress really is the physical and the mental reaction we have to a stressor, which is essentially anything happening outside of us that causes us stress," D'Eon explained.

Stress is our fight or flight reflex. In the animal kingdom, the threat is real, for example, prey trying to escape a predator. But for people, it doesn't have to be.

"Humans have this unique ability to imagine," D'Eon said. "So, we can just imagine something happening, either hasn't happened yet or we can think back into the past, and we can create and generate that same internal physical reaction."

Imagined or not, we've recently gone through what D'Eon calls "collective stress," like the impact of the pandemic.

"If we're already dealing with personal stress, it's just adding on extra layers of stress, globally," she said. "So, we're seeing this increase across the board for things like stress, anxiety, and depression."

A late 2022 poll from the American Psychiatric Association found 37% of Americans rated their mental health fair or poor, up from 31% in 2021. Meantime, 26% of people expected to be more stressed out this year.

Dr. Lori Daniels, a cardiovascular medicine professor and Director of the Cardiovascular Intensive Care Unit at UC San Diego Health, says she's seeing the results of that poll in her office.

"I'm seeing a lot more stress in my office in the clinic and in the hospital," Daniels said. "I have patients coming and telling me, 'I am stressed out and my blood pressure numbers are off the chart.'"

Daniels explained that while scientifically different from a cardiac event, like a heart attack, stress and anxiety do affect the heart and the cardiovascular system, especially in the long term.

"When someone is under stress, there's a lot of hormones that get released, the flight or fight hormones, like adrenaline," Daniels said. "That sends a direct signal to the heart to beat faster and beat stronger, and it triggers a whole cascade of effects."

Daniels further explained in a real heart attack, one of the blood vessels supplying blood to the heart is blocked, leaving the heart with insufficient blood flow and, essentially, part of the heart muscle is starting to die.

Some conditions can mimic a heart attack

The tricky thing is, your body might use the same symptoms like an ache in your arm, your neck, or chest pain to show you there's a problem. 

Daniels admitted, even among experts, it's not always clear cut.

There are even more conditions that can mimic heart attack symptoms. Stress Induced Cardiomyopathy is one of them which is commonly known as Broken Heart Syndrome.

"When someone has a major sudden stressor in their life, like the unexpected death of a loved one or a major operation or trauma, sometimes that can trigger a big heart-attack-like reaction that can be serious," she said.

Heart disease

  • CDC data shows heart disease is the leading cause of death for Americans, killing almost 700,000 people in 2020. 
  • In California, that number's about 66,500 people. 
  • In San Diego County, heart disease killed almost 2,100 people in 2021, making it the county's second leading cause of death, behind cancer.

While some stress here and there likely won't cause a heart attack, and is in fact healthy for humans, according to experts, long, unchecked periods of it are not.

"We are not going to function well if we are not doing things like sleeping sufficiently, eating, hydrating, taking care of ourselves by getting movement throughout the day," D'Eon said. "Those building blocks are so crucial."

And from her point as a cardiologist, Daniels agreed.

"There's a a huge link we don't understand between the mental world and the physical world, including the heart," Daniels said.

If you feel chest pain, shortness of breath, aches in your arms or upper body, go to the hospital. If you feel like you need help to manage your stress or anxiety, you can find help at places like Rogers Behavioral Health.

WATCH RELATED: The connection between oral health and heart disease (Feb. 2023).




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