Here are the sneaky ways your emotions can have concrete effects on your heart.
Stress certainly doesn’t feel good — it can cause disrupted sleep, eating issues, and a host of other problems. But can it be deadly, at least when it comes to your heart function? How does high blood pressure affect your heart, and how high is too high?
To get answers, Katie checked in with the beloved Dr. O — aka J. Nwando Olayiwola, MD, MPH, FAAFP, the Chief Health Equity Officer for Humana Inc. Here, she explains how persistent stress can trigger (or worsen) heart disease, and how keeping tabs on your blood pressure can be a life-saver, literally.
Can you explain the connection between stress and heart disease?
Stress is such an important factor. As you think about heart disease, you can have stress that positively impacts your heart, and you can have stress that negatively impacts your heart — and your mental health. This is a simple way of looking at it, but sometimes stress, pressure, and an inability to kind of relax contributes to poor behaviors, health-wise.
You might be really stressed and decide, “I need to take a puff of a cigarette to calm down.” Stress might lead you to overeating, or lead you to say, “I don’t really want to do much,” and make you be more sedentary. Maybe it leads to you not taking medications as prescribed.
So stress can lead to unhealthy habits, but it can also increase the amount of cortisol, a stress hormone, that your body produces. How does that increase your risk of heart disease?
Cortisol is almost like having jolts of steroids going through your body over and over again. And in a way, cortisol can be good when you have a stress response, if you need to figure out how to respond to a dangerous or scary situation. But over time, the accumulation of large amounts of cortisol can actually be toxic for the heart.
So stress can lead not just to unhealthy habits but also the high levels of cortisol that, over time, start to damage the vessels.
High blood pressure is another sign that you may be developing heart disease. How often should you get your blood pressure checked?
High blood pressure is definitely a risk factor and probably one of the most challenging risk factors for heart disease and cardiovascular disease in general, because it is so silent.
It’s very hard to know that your blood pressure is high. I’ve had patients tell me, “I feel like my blood pressure is so high.” And while that’s a subjective thought, it’s likely not necessarily something you can always feel. Now, if you’re at the point where you are symptomatic from that high blood pressure, like with blurred vision or chest pain or difficulty breathing, then it’s at a really bad point.
That’s why getting your blood pressure checked regularly is really important. Most doctor’s offices will check it every single time you come in — it’s a standard vital. But at least a few times a year, people should know what their blood pressure numbers are.
Is low blood pressure a problem?
Low blood pressure is interesting. Certainly for cardiovascular disease, you’d want to have it low, but low blood pressure can also cause challenges.
There’s no one number that you can say is definitively too low for everyone, but symptomatic low blood pressure can be problematic, because that can make people dizzy. You can also feel faint, lightheaded, dehydrated, or have a hard time seeing, with blurred vision. So trying to keep the blood pressure in a relatively normal range is good.
What about high blood pressure: What’s in the normal range?
So a normal blood pressure range depends on a number of things, like your age and other conditions you have. But generally speaking, there are two numbers: the systolic number at the top, and then the diastolic number at the bottom. We like that top number to be less than 100, which is ideal, and the bottom number to be less than 80. If you have diabetes, previous heart disease, or a stroke, those numbers can also change.
Getting a check frequently is important — not necessarily every day, but a few times a year. Knowing those numbers is really important.
I just turned 65. My mom had heart disease and selfishly, I want to know if there are certain tests that I should be taking — in addition to having my cholesterol and high blood pressure monitored — to determine if I might be developing heart disease?
There are a lot of tests out there that are able to help determine one’s risk level, their coronary calcium scores, or even CT scans with angiography, which has dye that goes through and looks at the heart there.
Now, not all those things are necessarily recommended, because there are some tests and markers that are easier to monitor which are really good predictors of heart disease: cholesterol, diabetes, genetic risk, blood pressure. If you have a strong family history of heart disease — particularly early heart disease — you may want to talk with your doctor about some of these other tests.
If you’re having symptoms like unexplained chest pain, those tests become increasingly more important, to really understand the level of heart disease you may have already. There are some genetic tests available, but I would say the most important thing is talking with your doctor to understand your risk profile and what tests might be best suited for you.
