Mental Stress May Play
Bigger Role in Heart Disease Than Previously Thought - Silent Ischemia
without Chest Pain and Symptoms
March 7th 2006
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According to research from the University of Florida, heart disease
patients could still pass stress tests done on a treadmill or with
chemical stressors after treatment, their hearts may still suffer silent
ischemia during mental stress. Ischemia means that a heart, or other
organ, does not get adequate blood flow and lacks vital oxygen and
nutrients.
The ischemia produced by mental stress has been associated with an
increased risk of death in heart patients, who also suffer ischemia
during physical stress. David S. Sheps, M.D, said that the study just
showed that mental stress ischemia can happen even in heart patients who
are free of exercise-induced ischemia. The researchers are not sure
whether the silent ischemia they detected is hazardous to the health of
the patients.
The researchers found that mental stress induced ischemia is more common
than had been recognized before. The research supports proposals that
suggest that mental stress works through a different mechanism than
physical stress.
Dr. Sheps, who is from the University of Florida, Malcom Randall of the
Veterans Administration Medical Center in Gainesville Florida, and the
lead author Srikanth Ramachandruni, M.D., monitored the heart blood flow
in 29 coronary heart disease patients as they performed a mentally
stressful role-playing scenario. All of the patients were being
treated, but none shoed signs of ischemia on either the treadmill tests
or after an injection of a chemical that puts stress on heart blood
flow.
Mental stress has been shown to produce ischemia in heart disease
patients who also have problems during exercise or chemical stress
tests, but this is the first such study specifically designed to look at
this broader group of patients.
The patients were asked to imagine a stressful situation, such as
learning that a relative was being mistreated in a nursing home, and
then give a short speech demonstrating how they would respond. After
one minute into the speech, the participants were injected with a
radioactive tracer. Of the 29 participants, six showed signs of
ischemia, although none of them felt chest pain or other symptoms of
ischemia and there were no important differences in heart rate or blood
pressure.
According to the American Heart Association (AHA), current data don't
yet support specific recommendations about stress reduction as a proven
therapy for cardiovascular disease. This research may add to the
evidence that suggests there is a relationship between cardiovascular
disease and environmental and psychosocial factors. The AHA also says
that acute and chronic stress may affect other risk factors and
behaviors, such as high blood pressure and cholesterol levels, smoking,
physical inactivity and overeating. The AHA says that after a heart
attack or stroke, it is common for people who feel depressed, anxious or
overwhelmed by stress should talk to their doctor or other healthcare
professional.
The new study appears in the Mar. 7, 2006, issue of the Journal of the
American College of Cardiology.
By Dan Wilson
Best Syndication Staff Writer
Books on Heart Disease
Keywords and misspellings:
ischemia aschemia
askemia isckemia iskemia coranary
micro-vascular disfunction
iscemic iskemic
ishcemic ishcemia angiograf blood presure
stroke embolism imbolism embilism embelism bloode clot |
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