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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."

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