Constantly feeling stressed out, anxious, and angry at the world isn’t going to do your health any favors. Feelings and emotions like stress and anger put one’s body, quite literally, on edge. These frenzied states of being can extract a huge toll on the body over time.
Consequently, stress and anger are often associated with an increased risk of developing various ailments. Heart disease, Alzheimer’s, and obesity just to name a few. Now, however, a new study from Yale University finds that stress and anger may exacerbate pre-existing issues among heart failure patients.
“Mental stress is common in patients with heart failure due in part to the complexities of disease self-management, progressively worsening functional limitations, and frequent symptom exacerbations and hospitalizations,” says lead study author Kristie Harris, a postdoctoral associate in cardiovascular medicine at Yale University, in a release.
The term “heart failure” refers to any situation in which a person’s heart fails to adequately pump blood throughout their body. Heart failure can happen abruptly and require immediate medical attention (acute), but it can also be an ongoing condition. In many cases, heart failure leads to a drop in ejection fraction, meaning the heart is pumping out a less-than-normal amount of blood each contraction. This research focused specifically on heart failure patients experiencing reduced ejection fraction.
“We have evidence that patients who experience chronically elevated levels of stress experience a more burdensome disease course with diminished quality of life and increased risk for adverse events. Clarifying the relevant behavioral and physiological pathways is especially important in the era of COVID-19 when the typical stressors of heart failure may be further compounded by pandemic-related stressors,” Harris explains.
Among the studied group of heart failure participants, researchers looked specifically to see how each person’s daily levels of stress and anger influenced their diastolic functioning. This refers to a heart’s ability to relax and fill up with blood in between contractions and is indicative of a healthy, functioning heart. If a heart failure patient’s diastolic functioning, and subsequent diastolic blood pressure, is all over the map they’ll have a greater overall mortality risk and a higher chance of suffering another major heart failure episode.
A group of 24 study participants filled out daily surveys for a full week describing their day-to-day experiences with stress, anger, and any other strong negative emotions. Next, each heart failure patient was asked to complete a “mental stress” test that involved both solving difficult math problems and recalling a recent stressful experience. Echocardiograms were also performed on two occasions (at rest, during the stress test) to measure diastolic functioning.
The results of all those tests and surveys suggest that stress and anger indeed influence diastolic functioning, potentially worsening both long and short term health outcomes among heart failure patients.
If a participant had reported feeling extra stressed or angry in the week leading up to the stress test, they showed worse resting diastolic pressure than others. Most study participants (14 out of the 24) also displayed changes in their diastolic functioning (elevated diastolic pressure, decreased left ventricular early relaxation) due to stressful episodes.
“Factors such as mental stress and anger often go unrecognized and are under-addressed,” comments senior study author Matthew Burg, a clinical psychologist at Yale. “This study contributes to the extensive literature showing that stress and anger affect clinical outcomes for patients with heart disease, adding chronic heart failure to the list that includes ischemic heart disease (narrowed arteries) and arrhythmic disease.”
The full study can be found here, published in the Journal of Cardiac Failure.