The importance of the Mind-Heart-Body connection is described in a recent scientific statement of the American Heart Association where an attempt is made to present the complex relationship between psychological stress and the occurrence of cardiovascular disease.
Stress can be caused by various situations such as difficult working conditions, financial difficulties, bad interpersonal relationships and traumatic experiences, etc. Studies have shown that emotions such as stress, anger or depression can increase the relative risk of developing acute coronary syndrome by 2,5 times. The attempt to etiologically correlate the above observations has resulted in two main theories. The first concerns the direct effect of psychological stress on the heart through the stimulation of the autonomic sympathetic system with a rapid increase in hormones such as catecholamines. The cocktail of these hormones can cause disorders in the circulatory system leading to heart failure. Takotsubo cardiomyopathy is a disease that is most likely associated with these processes.
The second theory is based on the specific way of life of people who are under intense psychological pressure. Smoking, obesity, diabetes and hypertension are common risk factors for cardiovascular disease found in these patients. Even the feeling of pessimism, as highlighted by a recent Finnish study, has been shown to increase the risk of cardiovascular complications.
It is important to note that in this study by the American Heart Association, emphasis is placed on the fact that most of the studies that have been done on this subject are observational studies due to the nature of these emotions. Although there is room for error and bias, however due to the good design of both the studies and their statistical analysis we can safely identify negative psychological health as a risk factor for cardiovascular disease.
On the opposite site, is the positive psychological state. Optimism, happiness, gratitude, wellness and self-awareness are some of the concepts that the American Heart Association defines as beneficial for cardiovascular health. For example, optimism, the feeling that everything will go well and the belief that they will have a positive outcome leads the patient to adopt proper lifestyles that protect him from cardiovascular disease such as exercise, smoking cessation and proper nutrition.
Based on the above, it is understood that the cardiologist must devote substantial time to investigating the patient’s psychological state. Recommendations for integrating the patient into specific exercise programs or meditation methods have been shown to improve both quality of life and survival. In persistent cases, the cardiologist can refer the patient to mental health professionals who can decide if the patient needs medication or some form of psychotherapy. Collaboration between specialties is the cornerstone of effective health care.
References:
Boehm, J., Chen, Y., Koga, H., Mathur, M., Vie, L. and Kubzansky, L., 2018. Is Optimism Associated With Healthier Cardiovascular-Related Behavior?. Circulation Research, 122(8), pp.1119-1134.
Levine, G., Cohen, B., Commodore-Mensah, Y., Fleury, J., Huffman, J., Khalid, U., Labarthe, D., Lavretsky, H., Michos, E., Spatz, E. and Kubzansky, L., 2021. Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association. Circulation, 143(10).
Pänkäläinen, M., Kerola, T., Kampman, O., Kauppi, M. and Hintikka, J., 2016. Pessimism and risk of death from coronary heart disease among middle-aged and older Finns: an eleven-year follow-up study. BMC Public Health, 16(1).
Steptoe, A. and Kivimäki, M., 2013. Stress and Cardiovascular Disease: An Update on Current Knowledge. Annual Review of Public Health, 34(1), pp.337-354.
