Financial Stress and Coronary Heart Disease

Written by: Irene Euodia
Medically reviewed by: Rob Philibert MD PhD

The past 18 months have been remarkably stressful for most of us. The pandemic has caused many people to lose their jobs. Many of those who did not lose their jobs outright have lost considerable income. The resulting need to cut expenses has resulted in the consumption of less healthy food and the abandonment of healthy habits, such as sometimes costly gym memberships. For most, monetary considerations affect a significant proportion of their daily decisions. The resulting physical and psychological stress can have a considerable impact on healthcare outcomes.

This impact of stress is particularly noticeable on the incidence of coronary heart disease, which is the major cause of heart attacks. Monetary-related effects on the risk are strong. People with significant financial stress are 13 times more likely to have a heart attack. Work-related stress effects are strong. Nearly 2/3rds of all employees state that work is an essential source of stress, with those who reported having moderate work-related stress have a 5.6 times higher chance of having a heart attack (Cardiovascular Business, 2017).

Researchers from the INTERHEART study have attempted to quantify the relationship between stress and heart disease. In their study, among those who experienced a heart attack, 96% reported some level of stress, and 40% reported experiencing severe levels of stress. These findings suggest that reducing stress might decrease the rate of heart attacks. However, one of the study authors, Dr. Denishan Govender, noted that only a few doctors asked about stress, depression, or anxiety during a general physical. He suggested that screening for these symptoms should become routine practice for clinicians. Just as we provide advice on quitting smoking, he also recommended that we provide patients with information on fighting stress.

Not all stress is harmful. Short-term stress is often good; some stresses lasting around minutes to hours and can help improve performance. However, longer-term stress or chronic stress, lasting from several hours to days, can be harmful. One material effect of long-term stress is the activation of the sympathetic nervous system. The resulting state of hypervigilance is associated with the constriction of microvessels throughout the body. Although this effect may be more common in women, it is men who have a more profound microvascular compression during stress and who may be more likely to suffer adverse clinical consequences. The repeated and frequent constrictions caused by stress exhaust the body and can cause a heart attack.

For either gender, financial stress can trigger a heart attack by increasing cardiac workload and decreasing cardiac resilience. The experience of living under financial stress can create feelings of inferiority, loss of status, and self-doubt. These feelings are, in turn, associated with elevated night-time catecholamine levels and disturbed sleep. These outcomes are in turn related to elevated blood pressure, which increases the amount of work that your heart must perform. Cardiac resiliency is diminished by less attention to healthy living habits. People under stress often exercise less often and consume more alcohol. They often abandon more costly and time-consuming healthy eating habits in favor of “fast food”-often laden with saturated fats, cholesterol, and added salt.

What can you do?

The first step is realizing that while experiencing stress is sometimes inevitable, suffering adverse effects from the stress is not inevitable. Take some time and develop an improved set of coping strategies to help you diminish its effects. Here are some tips that you can try:

  • Use your social network effectively. Make time for friends and family. Laughter and social engagement may ease stress and improve mood through conversations or physical activities.
  • Use relaxation techniques effectively. Mindful meditation and deep breathing can be done anytime during the day. Consider yoga, a combination of controlled breathing and relaxation, while stretching your stiff body under stress.
  • Use your pillow effectively. Sleep and stress are interconnected. Stress can keep you up at night, and lack of sleep can lead to more stress and poor performance. Try to have a bedtime routine and good sleep hygiene. For example, sleep in an excellent darkroom. Avoid alcohol and sugar before bedtime, and practice clearing your mind before bedtime.
  • Use your intellectual resources effectively. Cognitively restructure your world viewpoints. Visualize both positive and negative attributes about key situations. Attempting to see a ‘silver lining’ and adopting a more positive attitude may reduce stress.
  • Use the fire alarm when necessary. When the water gets too deep, call your healthcare provider. Human history has repeatedly shown that we are stronger together. Give your provider a chance to help solve the problems. You might just be pleasantly surprised at what they can do in a pinch.

In the meantime, here are some internet resources to start the healing:

Mindshift: a free app that uses cognitive behavioral therapy (CBT) that can help with new ways of thinking, reducing anxiety, and suggests healthy habits to start.

Take a Break!: a free app with quick stress relief meditation audios and podcasts, perfect for mid-day mind reset.

Better Help: licensed therapists to match with your specific needs available via telephone, chat, or video calls.

Headspace: a free meditation app with short audios for instant relief, advice, and has sleep feature. However, only limited audios are available for free.

If you are a school, college, or university student–check out your institution’s health benefits. Usually, free counseling is included in your tuition fees.

Without a doubt, the past 18 months have been stressful for all. You are never alone, and we are stronger together. Contact us at Cardio Diagnostics if you think we can be of additional help.

References:

  1. Financial Stress A Risk Factor for Heart Attack https://www.cardiovascularbusiness.com/topics/acute-coronary-syndrome/financial-stress-risk-factor-heart-attacks
  2. Financial Worries May Raise Heart Attack Risk by 13-Fold https://www.medicalnewstoday.com/articles/320037#Asking-about-stress-should-become-routine
  3. Women are More Vulnerable to Mental Stress-Induced Ischemia https://www.medscape.com/viewarticle/890644
  4. Financial Stress in Late Adulthood and Diverse Risks of Incident Cardiovascular Disease and All-case Mortality in Women and Men https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-17
  5. Chronic Stress Can Cause Heart Trouble https://www.heart.org/en/news/2020/02/04/chronic-stress-can-cause-heart-trouble
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