Study: Higher levels of stress increase blood pressure and risk of heart attacks

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(CNN) -

Does stress constantly circulate through your veins?

Even if your blood pressure is normal right now, high levels of stress can put you at risk of developing hypertension in the next decade, according to a new study.

When the stress hormone cortisol continues to rise over time, there is also an increased risk of stroke, heart attack or heart disease, according to research published Monday in Circulation, Journal of the American Heart Association (AHA).

This is another study that illustrates the relationship between a person's mind and heart health, said cardiologist Dr. Glenn Levine, a professor of medicine at Baylor College of Medicine in Houston, who was not involved in the study.

One more study that reinforces the idea that stress makes us unhappy and affects our health

"Stress, depression, frustration, anger, and a negative outlook on life not only make us unhappy, they negatively impact our health and longevity," said Levine, who chaired the AHA scientific statement on connection between mental well-being and heart disease.

In developing the AHA statement, "we looked at all the data we could find and concluded that negative psychological health factors, such as stress, were clearly associated with many cardiovascular risk factors," Levine said.

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The good news, according to Levine, is that because the mind, heart, and body are interconnected and interdependent, a person can also improve their cardiovascular health by striving for a positive psychological outlook.

"You can decide to change the way you think about that stressful situation or set limits: just by being mindful you can prevent that stress from becoming toxic to you," said Dr. Cynthia Ackrill, a stress management expert and editor of the journal. Contentment, produced by the American Institute of Stress.

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Analysis of stress hormones

The new study followed 412 multiracial adults ages 48 to 87 with normal blood pressure, measuring stress hormone levels in urine at various times between 2005 and 2018. Hormonal levels were then compared to cardiovascular events that could have occurred, such as high blood pressure, heart pain, heart attacks, and

bypass

surgery

.

"Previous research has focused on the relationship between stress hormone levels and hypertension or cardiovascular events in patients with existing hypertension. However, studies on adults without hypertension are lacking," says study author Dr. Kosuke Inoue, Associate Professor of Social Epidemiology at Kyoto University (Japan), in a statement.

The study looked at three hormones - norepinephrine, epinephrine, and dopamine - that regulate the autonomic nervous system and control involuntary bodily functions such as heart rate, blood pressure, and respiration.

Inoue and her team also looked at levels of cortisol, a steroid hormone that the body releases in reaction to acute stress, such as danger.

Once the danger has passed, the body reduces cortisol production, but if a person is continually stressed, cortisol levels can remain elevated.

"Norepinephrine, epinephrine, dopamine, and cortisol can increase with stress from events in life, work, relationships, finances, and so on," Inoue explains.

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Greater impact on the youngest

According to the study, doubling cortisol levels alone, but not norepinephrine, epinephrine or dopamine, was associated with a 90% higher risk of suffering a cardiovascular event.

Every time the combined levels of the four stress hormones doubled, the risk of developing high blood pressure increased between 21% and 31%.

The effect was most pronounced in people under the age of 60, a concerning finding, according to the researchers.

"In this context, our findings hypothesize that stress hormones play a critical role in the pathogenesis of hypertension among the younger population," they wrote.

The authors noted that the study had limitations, such as the lack of a control group and the use of a single measure, urinalysis, to test for stress hormones.

Still, examining urinary measurements of stress hormones over time is "clean and novel," Levine said.

"It's a somewhat objective way, the best we can say with imperfect tools, of categorizing the people who are likely to be the most stressed, for the longest time."

To do?

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You say, "Wait a minute. I want to know if I'm stressed, but I can't run for a urinalysis."

So how do I know if I am at risk for heart problems due to high levels of stress hormones?

"While we obviously don't all know what our urine cortisol levels are, there are ways to learn to self-reflect on whether we may have some negative psychological factors, particularly things like stress," Levine said.

"If we recognize that we tend to be frequently stressed, frustrated or angry, then it is helpful to reflect on what exactly are the things that lead us to stress," he added.

"Once we do, we can sit back and reflect and decide if it's worth allowing these things to lead to stress or frustration."

Being aware of what triggers your stress allows you to be able to stop those automatic hormonal responses before they trigger your circulatory system, Ackrill noted.

"The mechanism of stress is that we get excited about something, so our sympathetic nervous system speeds everything up. We need our hearts to pump quickly to keep our blood pressure high, so that we have good circulation and we can get away from danger," he said. .

"You have to intervene earlier, when you start mounting the stress response, with a deep breathing or other relaxation response," adds Ackrill.

That will allow your higher executive brain to kick in, giving you options on how to handle the situation.

"We often let our minds react quickly to something before we have time to allow our higher levels of cognitive functioning, our prefrontal cortex, to intervene," Levine said.

"We want to pause, reflect and digest it, and take a couple of seconds to decide what is the most appropriate way to react."

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