The husband of one of the teachers shot dead in the recent Texas school massacre in Uvalde died of a heart attack two days later, overcome with grief. As in this case, stress cardiomyopathy, commonly referred to as “broken heart syndrome”, can cause the heart to fail as a result of extreme grief, emotional distress or surprise. The risk of heart attack increases 21-fold within 24 hours after the loss of a loved one (NAMD, 2012).
While this is an extreme example of horrifically negative emotions leading to cardiac failure, we do already know that difficult emotions are shown to carry a risk of harming the heart. For example, a 2014 meta-analysis of 30 prospective studies (40 independent reports), with 893,850 participants and follow-ups ranging from 2 to 37 years, found that depression increased the risk of developing coronary heart disease or myocardial infarction by a whopping 30 percent (Gan et al., 2014). PTSD, anxiety, anger, frustration and unrelenting job stress all pose similar cardiovascular risks and likely share a common physiological pathway.
So, why am I telling you this when you may have been feeling good about life? Because the converse is also true, and that is very good news indeed.
Do positive emotions equal cardiac health?
Cultivating positive emotions, like gratitude, empathy and compassion, can give rise to a better cardiac state and create a circle of decreased stress and a greater sense of calm. This is especially helpful among those of us who worry and stress about our health.
The magnitude of the effects of optimism and cynical hostility on cardiac health was similar to the effect of hypertension for total mortality
In one large trial (Tindle et al., 2009), 97,253 healthy women were followed for over eight years. In this timeframe optimists were found to have a lower risk of chronic heart disease (CHD), including 30 percent lower CHD mortality and 14 percent lower total mortality. Those with higher levels of cynicism and hostility, on the other hand, were found to have a higher risk of early death, either from cancer or other causes.
The mechanisms for this phenomenon can be indirect, which many will feel is obvious, but there are direct effects as well. Pessimism and cynical hostility can affect the risks of physical disease via two main pathways:
- Directly by altering activation of the autonomic nervous system, hypothalamic-pituitary axis or other stress-response systems, which may, in turn, speed up the process of diseases such as atherosclerosis
- Indirectly by influencing health behaviours such as drinking excessively, vaping, smoking and poor eating
In this study, the magnitude of the effects of optimism and cynical hostility on cardiac health was similar to the effect of hypertension for total mortality.
Why is this important and what does this mean for vet professionals?
The fact that these psychological factors are modifiable increases their clinical relevance: if we change the way we behave and react, if we choose to live life more meaningfully and calmly, we can literally save our lives. What better incentive is there than to live a longer and healthier life? The answer: to live a longer, healthier and happier life.
Many of us already know that people with what is commonly referred to as a “Type A” personality have a higher risk of developing heart disease compared to others. Most vets and many nurses fall into that “Type A” category; however, thankfully more recent studies have shown that it’s only certain traits in this cohort that increase cardiovascular disease risk. For example, angry and hostile, anxious and narcissistic “Type A” individuals are all at increased risk of developing heart disease, as are “Type A” people with depression.
It follows that, by learning new ways of behaving and therefore new ways of being, we can use neuroplasticity to our advantage when it comes to cardiac health and longevity.
Emotions are the precursor of feelings. They originate in the limbic centres of the brain (the amygdala). This information is transferred to the prefrontal cortex, where we have our reasoning and planning centres of the brain, giving rise to feelings. António Damásio, chair in neuroscience as well as professor of psychology, philosophy and neurology at the University of Southern California, says that feelings are the meanings which we give to our emotions (Damasio, 2022). These meanings are usually based on previous experiences and memories.
By learning new ways of behaving and therefore new ways of being, we can use neuroplasticity to our advantage when it comes to cardiac health and longevity
For example, the emotion of alertness on hearing a door slam shut might elicit a feeling of fear in someone if they grew up in a household where doors were repeatedly slammed in anger. This feeling may then be accompanied by rapid heart rate, hypertension and hypercoagulability, along with other physical symptoms of fear. However, someone else who grew up in a household with parents in control of their reactions to emotions (emotional intelligence) would be more likely to have that same emotion of alertness but, in contrast, they would be more likely to progress to the feeling of curiosity: they might wonder about where the wind that caused the door to slam was coming from or wonder who had just come home.
The effects of our anger and rage on our children’s mental health has been discussed in previous articles. Now we can see that we also have a moral responsibility to be mindful of the effects of our out-of-control emotions on our children’s future cardiac health as they grow up, as well as our own.