Stress makes no noise, and so the damage to the heart builds up silently over the years
Ideally, the pool of candidates for screening should also include the vast number of people suffering from chronic stress
Key points
Who should undergo cardiovascular screening? If you’ve been living with high blood pressure for months or years, you might well be the ideal candidate – even though the first answer that springs to mind is: those with high blood pressure, diabetes or uncontrolled cholesterol. But now, a new British study – the largest of its kind ever carried out – suggests that the pool of ‘candidates’ for screening needs to be expanded, and significantly so. Ideally, in fact, it should also include the vast number of people suffering from chronic stress, regardless of whether or not they have traditional risk factors – but all the more so if they also have high blood pressure, diabetes or high cholesterol.
This is suggested by a study involving nearly half a million adults in the UK, coordinated by researchers at the MRC Laboratory of Medical Sciences (LMS) and Imperial College London. The underlying message is that chronic stress in everyday life can leave a lasting mark on the heart, with potential negative consequences for cardiovascular health and life expectancy. This is an observational study, which documents an association but cannot prove a cause-and-effect relationship; it certainly gives pause for thought, however, and prompts us to take stock: when was the last time I had a check-up?
The link between everyday stress and the heart is called inflammation
The mechanism by which stress causes damage to the heart is thought to be chronic inflammation, a condition in which the immune system remains activated – albeit weakly but for a long time – rather than switching off once the immediate threat has passed. This persistent, low-grade inflammation, which has already been linked to other diseases, ranging from cancer to diabetes, may also play a significant role in heart disease. In this study, inflammation was found to be linked not only to well-known factors such as smoking, excess body fat and a sedentary lifestyle, but also to adverse socio-economic conditions and psychological distress. This suggests that it may be one of the biological pathways through which the pressures of everyday life – from financial insecurity to mental health problems – affect the cardiovascular system.
To quantify this, the researchers analysed data from around 480,000 adults in the UK Biobank, assessing the presence and extent of inflammation using a blood biomarker (acetylated glycoproteins, or GlycA) and cross-referencing these values with images of the heart and genetic information.
A figure that gives pause for thought: +43%
Those found to be in the highest quintile for inflammation (i.e. 20 per cent above the average) had a 43 per cent higher risk of heart attack and stroke than those in the lowest quintile. This finding also held true for those with no pre-existing heart disease.
