February is the month of love and I want to show you how to love your heart. We’ve all heard stories about a relatively young person in a high stress job who sadly succumbs to a heart attack without any warning signs, but we never hear the reason why that happens. This article aims to shed some light on the stress/heart attack connection, and to offer some rays of hope to improve cardiovascular health.
The scary truth is that heart attacks in the younger person are the more dangerous type of heart attack, and usually this person succumbs to the heart attack with no medical warnings. This process begins with a condition called Atherosclerosis, where the artery walls that supply blood and nutrients to the heart, start to thicken due to plaque accumulation. A healthy artery is meant to be elastic and can expand where necessary to allow for blood flow. Over time, plaque accumulation leads to less elasticity and the inability of the artery to expand leading to a narrowing of the artery. Low density lipoprotein (otherwise known as “LDL” or the “bad cholesterol) will be damaged by a process called oxidation that takes places around the artery walls which results in a toxin that causes inflammation. LDL cholesterol will build up in the artery wall and will add to the plaque build-up.
At first this build up does not reduce the size of the artery, but expands outwards and is covered by a thin, fibrous cap. This is the most dangerous type of plaque because it is prone to rupture. If the plaque was older it would have a thicker fibrous cap and wouldn’t be prone to rupturing. The early fibrous caps that are thin can collapse under pressures and break open. How does this happen? There are a few things that come into play. One is that immediately after we eat a meal high in bad fats for a few hours our arteries cannot release an important chemical compound called nitrous oxide, which allows our arteries to enlarge and handle more blood flow. Second, if there’s high blood sugar such as in a pre-diabetic or a diabetic, the sugar can damage the fibrous cap and cause a tear. This is even more likely if the person has high blood pressure. The high blood pressure, along with the changes in the shape of the artery cause turbulent blood flow in that area of the plaque. So rather than the blood flowing smoothly through the area, the blood can start smashing against the fibrous cap over the plaque and break it open. Imagine a white water rapid and how intense that is.
The last important thing is what happens when the fibrous cap breaks. If you get a cut on your skin a scab will form. Within the artery when the fibrous cap breaks, the blood will start to clot and form a plug. If this plug grows large enough to block the whole artery, and that artery is supplying blood and nutrients to the heart, the muscle cells of the heart will start to die. This causes a sudden emergency heart attack, medically known as a myocardial infarction. What’s important to know is that the heart attack is not caused by the slow progression of the artery closing from the cholesterol building up in the artery because the body can form new branches of the artery to supply the heart. The slow progression of cholesterol build up leads to a different condition called Angina.
The Stress Connection
How does stress figure into all of this? Before answering this question it is important to understand the body’s stress response. When we encounter a stressor our body releases hormones from our adrenal glands that cause changes in our physiology such as an increase in blood pressure, rapid breathing, and insulin suppression, among other things. The reason is because our body is preparing to fight or flee a stressful situation and is ensuring that everything we need is ready to go. The insulin suppression results in more sugar in our blood stream for energy, the increased blood pressure pumps blood to our muscles so they can work to flee, and the rapid breathing provides our body with more oxygen in order to move fast.
Chronic stress makes a person more susceptible to experiencing moments of intense stress. So when a stressful situation arises, they react more intensely to the stress and this is when the danger begins. With this now extra stress the heart starts pumping faster and stronger, meaning the blood pressure spikes and the likelihood of a weak point in that thin fibrous cap breaking increases. There is an even greater chance of this happening if the person had a cigarette recently, or ate a high saturated fatty meal. This is because these both stop nitrous oxide from being released allowing for the artery to expand to accommodate the extra blood flow. And once that fibrous cap breaks there’s no turning back. Also, when we are under chronic stress we are also more likely to use coping mechanisms that are unhealthy for cardiovascular health such as smoking, over eating fatty or high carbohydrate foods, and increased sedentary lifestyle. These poor coping mechanisms can damage a thin fibrous cap which break it open leading to a heart attack.
While this all sounds scary, there is a lot we can do to take ourselves out of that heart attack risk category. Here are four quick tips to implement on a daily basis to improve your cardiovascular health:
- Stress Management: I have this first because I believe this is the most important place to start. Also, research demonstrates the effectiveness of stress management techniques at reducing our risk for coronary heart disease. Your stress management activity should be something that helps you relax which will take you out of stress mode. Some suggestions are meditation, deep breathing, a casual walk through a park, a relaxing bath at the end of the day, or maybe even splurging once and a while for acupuncture or a massage.
- Healthy Fats: Above I talked a lot about LDL or the bad fats, but I don’t want you to think that all fat is bad. In fact, some fats are good and can actually reduce your risk for cardiovascular disease. These fats are referred to as High-density lipoproteins (“HDL” or “good fats”). HDL helps to collect excess cholesterol and LDL and transports it from the arteries to the liver to be broken down for removal from the body. Higher levels of HDL can actually reverse a plaque formation. Sources of HDL are cold-pressed extra virgin olive oil, fish oil, fatty fish, and flaxseeds. One of the easiest ways to get some HDL on a daily basis (aside from taking a supplement) is to pour some olive oil onto a salad.
- Diet: Animal products like meat and dairy tend to be high sources of saturated fats and LDL. Consuming these foods in high amounts on a daily basis will increase your risk for high cholesterol and coronary heart disease. While there are some cultures that consume these foods in high amounts and tend to have little to no cardiovascular health risks, we need to keep in mind is that their lifestyles are quite different than ours: more active, little to no chronic stress, and a diet low in refined carbohydrates. A diet high in vegetables will reduce your saturated fat intake and will increase your fibre intake. A high fibre intake is good because soluble fibre will bind to cholesterol in our body and the insoluble fibre will help form the bulk of our stool that will push out this bound cholesterol. Aim to have some veggies at every meal.
- Exercise: Exercise has many important functions, but in terms of cardiovascular health it is important because it is one of the best ways of increasing HDL. As we said above, HDL can actually reduce the size of a plaque formation. Exercise also helps with circulation and weight management. It can also be an effective tool for stress management, allowing the person to work off the stress (and cholesterol) from the day. By doing that our mood becomes more balanced and it’s easier for issues to roll off our back.