A heart attack (or myocardial infarction) is a serious health problem that can result in death. In fact, almost one-third of patients who have their first heart attack die immediately, so researchers have looked into possible triggers that might play a role in provoking a heart attack. Though it sounds like an old wives’ tale, research within the last decade has shown a connection between stress and the onset of heart attacks. Let’s look at internal stressors and external stressors and their potential for triggering heart attacks:
Internal Stress Triggers for Heart Attacks
Anxiety and depression have long been associated with an increased risk of heart disease, but an analysis of a large number of studies (also called a meta-analysis) showed that anger, depression, grief, and chronic anxiety can be connected with the increased risk of a heart attack. One study by Möller et al. showed that an individual was 9 times more likely to have a heart attack within an hour after an angry response to a situation. Other studies looked at the effect of depression, discovering that the likelihood of a heart attack was 2.5 times greater in the 24 hours following a depressed mood. Another study looked at the effects of grief, noting that the risk of heart attack was increased 21 times within the first 24 hours after the death of a loved one, with the risk diminishing steadily every day after that. Regarding chronic anxiety, research showed that the risk for heart attack was 1.6 times higher for individuals who experienced high levels of chronic anxiety.
Some researchers may argue that the existence of these emotional states right before a heart attack might actually be pre-warning signs of the impending heart attack. Others say that inflammation in the body can create negative emotional states and that increased inflammation in the body precedes most sudden cardiac events. However, it is clear that internal stressors are somehow linked to heart attacks, either as a contributing cause or as an effect of the body’s inflammation.
External Stress Triggers for Heart Attack
Research has also indicated that external stressors, such as job stress, marital strain, and catastrophes, can play a role in triggering heart attacks. Job stress, when defined as “high psychological workloads” with low levels of control or decision-making authority, appears to be linked to an increased risk of heart attacks in men more so than women, according to researchers Schnall et al. On the other hand, marital strain had a greater triggering effect on women, with research indicating a 3 times greater risk of heart attack for women experiencing marital strain. Other studies have looked at the connections between catastrophes, like earthquakes, and increased heart attacks. One such study reviewed data from hospitals in the greater Los Angeles area a week before and a week after the Northridge earthquake struck on January 17, 1994, noting a sharp increase in the number of sudden deaths from heart attacks in those with cardiac risk factors along with an overall, four-fold increase in heart attacks.
While researchers may disagree about whether stress is a cause or another symptom of a heart attack, it is clear that there is a link. Doctorpedia recommends talking to your physician about ways you can reduce your risk factors for heart attack and better manage the stress in your life.
- Arnold, S. V., Smolderen, K. G., Buchanan, D. M., Li, Y., & Spertus, J. A. (2012). Perceived stress in myocardial infarction: long-term mortality and health status outcomes. Journal of the American College of Cardiology, 60(18), 1756–1763. doi:10.1016/j.jacc.2012.06.044
- Chi, J. S., & Kloner, R. A. (2003). Stress and myocardial infarction. Heart (British Cardiac Society), 89(5), 475–476. doi:10.1136/heart.89.5.475
- Edmondson, D., Newman, J. D., Whang, W., & Davidson, K. W. (2013). Emotional triggers in myocardial infarction: do they matter?. European Heart Journal, 34(4), 300–306. doi:10.1093/eurheartj/ehs398
- Möller, J., Hallqvist, J., Diderichsen, F., Theorell, T., Reuterwall, C., & Ahlbom, A. (1999). Do episodes of anger trigger myocardial infarction? A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP). Psychosomatic Medicine, 61(6), 842-849. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10593637/
- Orth-Gomér, K., Wamala, S.P., Horsten, M., Schenck-Gustafsson, K., Schneiderman, N., & Mittleman, M.A. (2000). Marital stress worsens prognosis in women with coronary heart disease: The Stockholm female coronary risk study. JAMA 284(23):3008–3014. doi:10.1001/jama.284.23.3008
- Schnall, P.L., Landsbergis, P.A., & Baker, D. (1994). Job strain and cardiovascular disease. Annual Review of Public Health, 15, 381-411. doi:10.1146/annurev.pu.15.050194.002121
Nan Kuhlman is an author, freelance writer, and part-time university professor based in Los Angeles, CA. She currently works full-time as a technical writer in Los Angeles and part-time as an online adjunct writing instructor. She has written for scholarly publications like the University of California, Davis Writing on the Edge and Chapman University’s Anastamos Interdisciplinary Journal, among others.