HEART OF THE MATTER

Your heart does much more than simply pump blood and miss a beat when your head is turned. In fact, it’s an exquisitely sensitive instrument that may be more in touch with your emotional intelligence than you realise. Maximise its potential and safeguard

Your brain and heart health are inexorably linked. Here’s how to get smart about both

on an unconquered Himalayan peak, Conrad Anker felt an unusual sensation: he was tired. For a typical 53-year- old, this would not have been surprising. Anker had been climbing for seven hours to the 22,621ft summit of a peak called Lunag Ri. It was enough to beat anyone. But Anker was not just anyone; as an acclaimed mountaineer he was in remarkable shape and, four years earlier, had become one of a handful of people to summit Everest without supplemental oxygen. In theory, the man was nigh on indefatigable.

But, on 16 November 2016, Anker stopped climbing and sat down. At first he thought it was altitude sickness. Then it hit him: this was something else. Just a few months earlier, before trekking Mount Kilimanjaro, Anker had undergone a battery of heart tests. Everything had checked out perfectly. So, at 3000ft from the summit of Lunag Ri, a sensation Anker described as a “severe muscle pain in my heart” was cause for deep concern.

Anker and his partner David Lama rappelled the mountain back to base camp where 26-year-old Lama made the crucial decision to call for assistance. A helicopter transported Anker to a Kathmandu hospital where doctors discovered the problem: he had experienced an acute thrombotic occlusion of his anterior descending coronary artery – in other words, a sudden heart attack. The culprit was a crumbsized piece of fatty plaque blocking one of the main blood vessels to his heart. Nine hours after Anker first felt his chest tighten, doctors inserted a stent in the offending vessel and saved his life.

Every year around 73,000 people die from coronary heart disease in the UK, with heart complications costing the NHS an estimated £11bn. Few are world-class athletes like Anker. His episode could have been caused by genetic bad luck, or the compound stresses of a lifetime of extreme demands on his most important organ. But Anker pinpointed another possible cause: grief. Five months earlier, Anker had trekked up Tibet’s 26,335ft Shisha Pangma to retrieve the body of his best friend, Alex Lowe, who had died in an avalanche. The mission was successful and Anker carried his friend’s body down the mountain himself. “Going back up there was very emotional,” he said at the time. “I was stressed, and I felt my heart.”

Even before we understood how it does its primary job of pumping blood, the heart was a powerful symbol of emotion, from love (“with all my heart”) to conviction (“I believe in my heart”) and truth (“the heart of the matter”). But metaphysical associations aside, studies have proven that our emotions can directly affect our heart health in tangible ways. This may be why, according to research in the European Journal of Epidemiology, 20% more men suffer heart attacks on Mondays compared to any other day of the week. When Anker said that his friend’s death had touched his heart, it probably did.

When it comes to protecting our hearts, most men are well versed in classic risk factors such as high blood pressure and cholesterol, but we tend to miss the mental and emotional clues our hearts offer up. In addition to pumping blood, your heart acts as a useful indicator of your level of fatigue or stress, and the state of your relationships. By doing all of this, your heart keeps you alive; but ignore its warning signs and it can also kill you. With this in mind, we’ve compiled a guide to understanding exactly what your heart does to keep life ticking over, and how best to work with it to safeguard your health. After all, the better you look after it, the better it will look after you.

01 GET HIGH ON LIFE

“The heart is the only organ that is in continuous motion,” says Dr Euan Ashley, a cardiologist at Stanford University. Around 70 times a minute, 100,000 times a day, the four chambers of the heart expand and contract to circulate the equivalent of 8000 litres of oxygen-rich blood through your body. Despite this wear and tear, its valves keep blood flowing in the right direction without breaking down or stopping, even while you sleep.

And – as any good personal trainer will tell you – due to an increased demand for oxygen in the muscles, men who exercise regularly are able to pump more blood with each heartbeat than those who are less active. If you really want to gun it, harnessing the power of gravity through ‘pulmonary shunt’ training will force your heart to work at its optimum. By alternating between upper- and lowerbody exercises with minimal rest – think bench press to box jump, or squats paired with max pull-ups – you’ll send blood racing in all directions, spiking your metabolism in the process.

Not only this, research published in the journal Medicine & Science in Sports & Exercise suggests the more punishing (and painful) your workout, the greater the amount of mood boosting neurotransmitters, such as endorphins, serotonin and anandamide, your body will pump out. In other words, the perfect chemical cocktail to provide that post-workout mental high.

02 DRINK TO THE RHYTHM

Dr Ashley is captivated by a unique property of the heart: “If you remove it from the body and keep it supplied with energy and oxygen, it will continue to beat on its own,” he says. That’s because the organ has its own electrical system, with special cells that generate regular, rhythmic pulses, stimulating the heart to contract and relax. And if some of those cells conk out, others can take over.

But it’s still a vulnerable system and problems with the complex nerve network can lead to rhythmic disturbances. In the worst case, these cause the heart to simply stop. “In more than 90% of such instances the result is death,” says Dr Jeffrey Ardell, director of the Neurocardiology Center for Excellence at UCLA.

To reduce your odds of becoming a statistic, the Journal of the American

“OUR EMOTIONS CAN DIRECTLY AFFECT OUR HEART HEALTH IN TANGIBLE WAYS”

College of Cardiology dryly recommends cutting back on the sauce. But restrictive prescriptions aren’t what we’re interested in. Luckily, nutritionist Joe Sexton has a solution that covers all bases: “Alcohol can flush out heart-helping B vitamins, so load up on something high in protein and fibre while you drink – call it a beef burger in a wholemeal bun – to provide enough B vits to cancel out any loss.” Not only that, B vitamins are a vital component of mood-boosting serotonin. By topping up your reserves during that after-work pint, you’ll safeguard your heartbeat. And you might even survive the hangover, too.

03 SWEAR BY IT

Reassuring news for Morrissey fans: according to research, your lonely heart may actually be grounded in science, rather than your imagination. Scientists have observed that people who suffer sudden, severe trauma often exhibit physical wounds on their pericardium (the outer layer of heart muscle), brought about by high levels of stressneurotransmitters called catecholamines. Love can hurt, it seems. But men are also at higher risk from another, all-toofamiliar emotion: anger.

According to studies from typically mellow Canadians, your risk of heart attack goes up by 250% in the hour following you flipping your lid. The solution comes in the form of a four-letter word. While children cry to express anger or stress, men have evolved to swear. Research by Professor Richard Stephens, a senior lecturer in psychology at Keele University, found that swearing occupies a completely different section of the brain to our usual language skills – the left hemisphere, rather than the parietal lobe – and its effects are unique compared to other language processes.

Letting fly the odd blue outburst not only works as an analgesic, but increases heart rate and releases adrenaline – making it an ideal way to tear through that last 1km standing between you and a PB (to try it for yourself, see p48). Add some timely NWA to your cardio playlist.

04 FIGHT THE FLIGHT

Your heart rate is constantly changing, even from beat-to-beat. According to Dr Reginald Ho of the Thomas Jefferson School of Medicine, that’s because the heart is governed by two competing halves of your autonomic nervous system. Your sympathetic system responds to

threats with the fight- or-flight response, which speeds up your heartbeat leading to higher blood pressure and a greater risk of cardiac events. But when the parasympathetic nervous system is dominant, as it is in practised athletes, the rate settles down and becomes more variable – a marker of good health.

According to a recent study, it may be possible to acquire this skill within just one week. Harvard researchers asked participants to pause and note their heart rate every three hours throughout the day. When taken to the lab for testing a week later, this ‘hyper-awareness’ group were able to stabilise their racing hearts simply by focusing on dropping the beat. An unpractised group struggled to do so.

The key to a truly balanced approach for body and mind lies also in embracing the sympathetic response. In a study carried out by Dr Kelly Mcgonigal, a lecturer at Stanford University and the author of The Upside of Stress, the brains of those who saw the body’s fight-orflight reaction as positive released more of the hormone DHEA during stressful situations, slashing their risk of anxiety.

Remaining calm when your boss gives you a 30-minute deadline, then, will provide an adrenaline boost without leading to major blood pressure spikes that would put extra strain on your heart. And engaging the parasympathetic nervous system during the course of a longer project will crush cortisol’s harmful effects on both body and mind.

05 STICK TO THE BEAT

As an organ, your heart is more than purely mechanical: its ganglia (a cluster of nerve structures that operate almost like a rudimentary brain) respond to sensory input from the world around you. Dr Peter Sleight, a retired Oxford University researcher, has studied the effect of music on our cardiac rhythms and discovered that blood pressure and heart rate rise and fall to match the volume and pace of music.

It’s a useful training tool, especially so when you consider that a second study published in the Journal of Pain found that music can reduce the level of perceived physical discomfort, leading to a form of “music-induced analgesia”. In the study, subjects were given either no distraction, or music to listen to while holding their hand against a heated stimulus. After the experiment, those in the group listening to music ranked their pain significantly lower than the other participants and, crucially, were able to endure it for longer. The researchers studied the results, finding a suppression of activity in the neural structures associated with pain modulation, including a brain region called the somatosensory cortex.

What this means is that the right playlist will synch with your heart rate, which in turn will direct your brain as to the level of effort it should perceive, whether in the office or working out. Beats of 130-140bpm work well for heavy lifting, pushing you to continue without letting you speed up and break form (think Gorillaz’ Feel Good Inc or Iggy Pop’s The Passenger). Meanwhile, a tempo of 120bpm will help you cool down at the end of the tough session, or slide back into office mode without too much disruption. As well as neatly describing your afternoon, Queen and David Bowie’s Under Pressure happens to be the perfect fit.

06 EASE THE PRESSURE

The heart is a uniquely durable organ with the ability to protect itself – and your brain – in a way that no other part of your body can. Because heart cells don’t divide and reproduce after infancy, they are uniquely less susceptible to developing tumours. And, even when blood flow to the heart becomes restricted, it can still beat. “My doctor told me I had basically trained myself to survive,” Anker says of his high-altitude mishap. “By staying fit and spending so much time at altitude, my heart understood the duress it was under, and when it failed, other parts [of the muscle] were able to take over.”

Research from Germany suggests that people who exercise regularly may heal faster after a heart attack than those who don’t – in part because working out reduces heart attack-induced scarring and inflammation. That was the case for Anker: two months after the incident, his ejection fraction – a measure of pumping efficiency – had recovered, placing it back within the ‘normal’ range. And his heart muscle bore no permanent damage. But if running up stairs rather than slogging it up the South Col is more your pace, you needn’t worry. A second study published in The Journal of Applied Physiology looked at former British Olympic athletes aged 26-50 and found that while none of the athletes were suffering from obvious symptoms of cardiovascular issues, half of the older bunch did show signs of scarring in their hearts – proof that decades of dialling it up to 11 isn’t the best way to safeguard your longevity.

As for Anker, daily meditations, tracking his heart rate with a fitness device and attempting to avoid stressful stimuli are all playing a part in his slow road to recovery. Eventually, he plans to ease himself back into climbing, but not all strategies for a healthier heart need to be mountainous endeavours: “I saw something in the news the other day that spiked my heart rate up to 128,” Anker says. “So last Tuesday I took a day off from social media. It was great.” With increasing evidence that stressful news can boost cortisol, crush your immune system and inhibit the release of growth hormones, it appears that where your heart and mind are concerned, no news really is good news.

“SUBJECTS WERE ABLE TO STABILISE THEIR HEARTS JUST BY FOCUSING ON THE BEAT”