How your emotions can save/stop your heart
Is it time to view the treatment of heart disease in a more encompassing way? UAE cardiologists share their view
It’s time cardiologists began to address emotions to treat heart disease
1 Should the next big frontier in heart disease treatment and management focus on an integrated approach?
Dr Brajesh Mittal: “It is true that emotional state affects the biological state of the body, including the heart. The adverse effects of acute as well chronic stress have been demonstrated in studies. However, stress should be considered as a factor, a contributor. That is not to say ‘stress causes heart disease’. And like other cardiovascular factors, it is modifiable.”
Dr Firas Raouf: “Absolutely, I totally agree.”
2 Should emotional stress be listed as a key modifiable risk factor for heart disease?
Dr Mittal: “Stress is a very subjective factor. Also, it is not quantifiable the way cholesterol is. So [stress] is more difficult to recognise, assess and modify as compared to modification of cholesterol.”
Dr Raouf: “[Yes]. I believe modifying emotional stress can impact significantly the rate of cardiac events. Today, there exist therapy systems to minimise effects of stress on the body in general and cardiovascular health specifically. The challenge with emotional stresses is that no quantifiable markers have been yet defined to monitor the level of stress a human body is being actively exposed to.”
3 Cardiologists are not counsellors. Comment.
Dr Mittal: “I believe all the physicians are de facto counsellors. Whenever we treat a patient, we almost always end up giving some psychological counselling — it may be subtle, indirect or sometimes, more direct. The role of medicine is to provide physical, mental and emotional well-being; not just the drug prescription.”
Dr Raouf: “I don’t think it will blur the line. Since the psychological aspect is considered an integral part in many aspects of healthcare delivery, I think this would rather strengthen the collaboration and inter-referral practice between both teams, psychologists and clinicians.”
4 Can one die from a broken heart?
Dr Mittal: “People can die from stress-induced cardiomyopathy; though, in most cases it is reversible, and heart function returns to normal after several days.”
Dr Raouf: “Patients who suffer ‘Broken Heart Syndrome’, can be perfectly healthy people prior to their exposure to a dramatic emotional stressful event, predating the onset of this condition and [it] can sometimes ultimately lead to their demise.”
Had the landmark US Framingham Heart Study included psychosocial determinants of heart disease, would history of heart disease management have been different?
Dr Mittal: “To some extent, yes. But not wholly.”
Dr Raouf: “I believe it would have, as we are now realising the significant impact emotional stress can have on heart disease, brain disease, cancer and many other illnesses. Hence, monitoring and controlling the magnitude of emotional stress would, I believe, have a measurable positive impact.”
What’s the way forward?
Dr Mittal: “Diverse and effective stress intervention programs have been tested in heart patients, programmes that provide formal psychotherapy, psychotropic medications, time management training, progressive relaxation training, meditation, or regular exercise. The therapeutic nihilists are wrong. The majority of these intervention programs improve patients’ morale and functioning.”
Dr Raouf: “Researchers, clinicians, and psychologist should work together in trying to define measurable markers defining emotional stress.
“People should be more aware of the negative effects of emotional stress and try to implement lifestyle changes adequate rest and sleep, regular exercise, focus on mind health (yoga) and being with positive people. “Governmental and societal bodies [should] continue to focus on the individual’s healthy mind by creating support groups for counselling and advice.”