Emotional stressors trigger cardiovascular events

Abstract

Summary Aims: To describe the relation between emotional stress and cardiovascular events, and review the literature on the cardiovascular effects of emotional stress, in order to describe the relation, the underlying pathophysiology, and potential therapeutic implications. Materials and methods: Targeted PUBMED searches were conducted to supplement the authors’ existing database on this topic. Results: Cardiovascular events are a major cause of morbidity and mortality in the developed world. Cardiovascular events can be triggered by acute mental stress caused by events such as an earthquake, a televised high‐drama soccer game, job strain or the death of a loved one. Acute mental stress increases sympathetic output, impairs endothelial function and creates a hypercoagulable state. These changes have the potential to rupture vulnerable plaque and precipitate intraluminal thrombosis, resulting in myocardial infarction or sudden death. Conclusion: Therapies targeting this pathway can potentially prevent acute mental stressors from initiating plaque rupture. Limited evidence suggests that appropriately timed administration of beta‐blockers, statins and aspirin might reduce the incidence of triggered myocardial infarctions. Stress management and transcendental meditation warrant further study.

Chronic stress impacts the cardiovascular system: animal models and clinical outcomes

“…In a study by Gullette et al (126) mental stresses, which were defined as feelings of tension, frustration, and sadness, were found to double the risk of myocardial ischemia. Many other epidemiologic studies confirm this relationship (176,294,366). For instance, for people who routinely work on a Monday-to-Friday schedule, the risk of adverse cardiovascular events is lower on Saturdays and increases on Monday mornings (366).…”

“…(176). Anger tantrums, death of loved ones, and work pressures are among other psychological stresses that significantly increase the rate of myocardial infarction (294). Another potentially neglected parameter in stress induced cardiovascular disease is the role of nutrition.…”

Grand Sumo Tournaments and Out‐of‐Hospital Cardiac Arrests in Tokyo

“…Sports events, earthquakes, and war can all induce environmental stress in a large number of people in defined areas 1. Objective evidence of triggering comes from earthquakes in Northridge in Southern California in 1994,2 in Hanshin‐Awaji in Japan in 1995,3 and in Great East Japan in 2011 4.…”

Running training attenuates blood pressure and norepinephrine responses to immobilization stress in spontaneously hypertensive rats

“…Finally, the attenuated BP and NE responses to immobilization stress seen here indicate that, in SHR, cross-adaptation may occur between chronic exercise and novel stress. It is widely accepted that acute stress elicits an increase in BP and that when animals are repeatedly exposed to stresses, they often develop hypertension [2][3][4] . Chronic exercise is well known to have therapeutic effects on hypertension, and cross-adaptation between exercise and stresses might partly underlie such a contribution of chronic exercise to an improvement in hypertensive states.…”

“…A host typically reacts to a stressful stimulus with an increase in the activity of the sympathetic nervous system, leading to rises in blood pressure (BP) and heart rate (HR) 1,2) . Furthermore, repeated stress-exposure (i.e., chronic stress-exposure) can result in the development of stress-related disorders such as hypertension 3,4) ; and it is well known that appropriate lifestyle modifications, such as increased physical exercise, can have therapeutic effects on hypertensive patients.…”