New research shows risks posed by
psychological and social factors almost as great for heart disease
as obesity, smoking and hypertension
NEW YORK, Sept. 25 /PRNewswire/ -- For a long time, cardiologists
resisted the
idea that the heart, the sturdy wellspring of life, can be fatally
deranged by a mental event. But mounting evidence suggests that
chronic
emotional states such as stress, anxiety, hostility and depression
take a
significant toll, Newsweek reports in its cover story "Health For
Life: The
Soul of a Healthy Heart," produced with Harvard Medical School.
"Fifty percent of
people who have heart attacks do not have high cholesterol," says
Edward
Suarez, associate professor of psychiatry and human behavior at Duke
tells
Newsweek in the October 3 issue (on newsstands Monday, September
26).
The risk of psychological and social factors are almost as great as
the
traditional medical markers for cardiovascular disease, including
obesity,
smoking and hypertension reports Correspondent Anne Underwood.
A
growing
number of clinics are putting that insight to work in programs that
tackle
heart disease at one of its most unlikely sources: in the mind. As a
critical
care nurse, Debra Moser, now a professor of nursing at the
University of
Kentucky in Lexington, saw repeatedly how patients' attitudes seemed
to affect the
course of their heart disease.
She was struck by one case involving
a man
with an uncomplicated heart attack who should have been out of the
hospital
within two or three days, but he lingered for six. "It was the first
time I
appreciated the power of negative thinking," says Moser.
"He was
very
depressed, which is not unusual after a heart attack. But he
obsessed over
everything. He was hypervigilant about his case. It seemed to us
that he
worried himself into episodes of recurrent ischemia and chest pain."
The chest
pain wasn't just in his mind; tests showed reduced blood flow to the
heart.
Within a year, he suffered another heart attack and died.
As researchers dig deeper into the underlying mechanisms of heart
disease,
they're finding that inflammation provides at least a partial
explanation for why
stress and negative emotions are so deadly.
"Hostile and depressed
people
respond to the world in a chemically different way," says Suarez.
They
interpret more situations as stressful, provoking the release of
more stress
hormones. The immune system responds by ratcheting up inflammation,
which
promotes heart disease at every stage -- from plaque formation to
heart
attack.
On the other hand, friendship, optimism and even laughter seem to
have
protective effects, and doctors and patients are now working to tap
their
healing power. The new approach integrates lifestyle changes with a
new
outlook on life. It will involve a collaboration among cardiologist,
nutritionist, psychologist, the patient and his family, bound
together by the
realization that the heart does not beat in isolation, nor does the
mind brood
alone.
Also in the Health for Life package, written by Newsweek
correspondents and
experts from Harvard Medical School
* Senior Editor Geoff Cowley and Correspondent Karen Springen report
on a new way to prevent heart disease -- an approach that involves
changing people's environments instead of scolding them about their
behavior.
Diet and lifestyle may hold the secret to long-term health,
but as researchers are now discovering, behavior is not just a matter
of choice. Every aspect of our lifestyles -- what we eat, whether
we smoke,
how much we exercise -- is shaped by our surroundings, Cowley
and
Springen report. Public agencies are now teaming up with
foundations, universities and private companies to make communities more
hospitable to pedestrians and bicyclists, and to make fresh, whole food
more accessible and attractive to kids.
"We've spent years making
the healthy choice the most difficult choice," says Ross Brownson, an
epidemiologist at St. Louis University. "We need to make it the easy choice."
* Correspondent Anne Underwood examines how researchers have found
that for most of us, the cardiovascular benefits of a daily drink
will probably outweigh the hazards whether its wine, beer or
spirits.
Research indicates that the major benefit of alcohol seems to
come from
its ability to boost levels of HDL, the good cholesterol that
helps keep arteries clear of plaque. "Depending on the individual, you
can get increases of 10 to 30 percent in HDL in a week," says Harvard epidemiologist Eric Rimm. "Nothing else in the diet can have
such a ramatic impact on HDL in such a short time."
* Correspondent Jennifer Barrett talks to Arkansas Governor Mike Huckabee, whose
recent life change inspired him to launch the Healthy Arkansas initiative
to encourage residents to stop smoking, exercise more and eat better.
"We need to rethink our approach to health care," says Huckabee.
"The
health-care system now focuses on disease, not health. We train doctors
how to diagnose and treat disease. We don't train them to prevent
disease. We pour most of our research-and-development money into
medications, not into helping people stay well."
* Assistant
Editor Mary Carmichael reports on a promising new approach to treating
heart failure -- a condition that affects 5 million Americans alone.
The dream is to restore dead or damaged heart muscle by treating patients
with stem cells -- immature cells that can be coaxed into
transforming into many different types. In early studies of the technique,
some patients have experienced Lazarus-like recoveries, but the field
is controversial since no one can explain exactly how the injected
cells are affecting the heart.
* Senior
Editor David Noonan reports on minimally invasive heart surgery. Although
open-heart surgery remains the norm in the United States, a growing
number of doctors and medical centers are offering heart patients
new options that involved much less wear and tear on the body.
* Senior
Writer Claudia Kalb reports on fetal intervention, an
experimental procedure in which babies with heart defects are
operated on while
still in the womb. The potential payoff is huge: warding off a common
defect in which a blockage in the atrial septum keeps the left side of a
baby's heart from developing normally. It's way too early to claim
victory, but Dr. Jim Lock, cardiologist in chief at Children's Hospital
Boston, is optimistic: "This is clearly the wave of the future."
