Stress linked to future cardiovascular events

Stress linked to future cardiovascular events

Strong evidence you can reverse risk and improve performance through stress reduction:

Everyone knows stress is not a good thing, unless you are under attack by a prehistoric animal and need the “fight or flight” response you inherited from your ancestors[1].  Most people in our society experience chronic stress from work, relationships, insufficient sleep, and various unhealthy habits. It should come as no surprise that neuroscientists are eagerly taking a look at the human brain, stressed out, using cutting edge technology.

A very recent study[2] has firmly established the direct link between stress and the amygdala, a region in the brain activated by stress and subsequent cardiovascular disease.  The study examined 293 patients averaging about 55 years of age, and followed them for 3.7 years.  Patients with increased amygdalar activity, a biomarker of chronic stress, had increased bone marrow activity and inflammation, both of which are independent predictors of heart disease.

Careful reading of this study showed that heart attacks and stroke could actually be predicted and quantified with remarkable precision.  All 293 patients studied had full body ¹?F-FDG PET/CT scans between 2005-2008 screening for cancer but were found to be cancer free.  This represented a “convenience sample” of subjects free from disease who could be studied for subsequent heart disease disease events, exploring the relationship between amygdalar activity and actual events.  After 3.7 years, 22 of the 293 patients had 39 cardiovascular events such as heart attack, unstable angina, bypass surgery etc.  Amygdalar activity was associated with increased bone-marrow activity (r=0.47; P<0.0001) and arterial inflammation (r=0.49; P<0.0001).  A dose response curve was calculated that for each standard deviation of increase in amygdalar signal activity, there was a 160% increase in the risk of cardiovascular disease events.

The good news is that there is growing evidence that mindfulness, a secular form of meditation, can significantly reduce chronic stress, reduce inflammation[3],  and reduce the risk of heart disease[4].    As a result, neuroscientists and cardiologists are looking to diagnose and treat chronic stress as an independent risk factor, in line with smoking, diabetes, cholesterol, excessive sitting, and other risk factors.  All these studies use the Perceived Stress Scale to identify patients at risk. You can even test yourself.  If you score more than average for your gender and age, you might be at risk and would benefit from stress reduction.  Any score above 20 confirms you are under sufficient stress to pose a health risk and affect your quality of life.

If the science of stress reduction tells us that meditation can lower stress, and that this can reduce cardiovascular disease, is there any good scientific evidence that it actually reduces meaningful outcomes in patients with heart disease?  A recent study involving 151 cardiac patients in a cardiac care program (over a five year period) discovered a stunning 50% reduction in actual cardiac events[5].

Bob McDonald, host of CBC’s Quirks & Quarks radio broadcast, recently reviewed the literature and did a little experiment on himself in a recent episode entitled: The Science of Mindfulness.  The important take-home message from his review is that the science of mindfulness confirms a real change occurs in both the chemistry and structure of the human brain engaged and trained in mindfulness.  Importantly, mindfulness produces a mental “state” that over time generates a durable neurochemical and neurostructural change in the brain or “trait” that is associated with less perceived stress and improved human performance.

I began teaching meditation to my pilots, air traffic controllers, and other aviation professionals when I started my aerospace medicine practice in 1986.  Using an approach that emphasized training the mind over making a diagnosis of a stressful condition (anxiety, depression, substance abuse, relationship dysfunction etc), pilots were able to adopt a simple 10-20 minute daily “cognitive simulator training” session and then develop the cognitive, emotional and behavioural skills we all attribute to the experienced captain handling an in-flight emergency with a calm, clear, stable state of mind, like Sully Sullenberger’s remarkable landing of US Airways Flight 154 in the Hudson river.  It’s worth listening to the recording of this crash to hear the tone of voice of this remarkable pilot.

At DeerFields, we offer a Tuesday evening small group stress reduction training program called “Mindfulness & Meditation” to everyone enrolled in our Vitality + Longevity Program (myVLP).  This program builds on more than 30 years of experience training pilots, executives, couples, soldiers, and athletes to manage stress, and can be incorporated into your own daily life.

MINDFULNESS & MEDITATION

Small group meditation training for beginners or those with experience

Every Tuesday evening 6 pm – 9 pm

DeerFields Clinic in the Party Room Main Floor

Enter through Townhouse # 2

133 Hazelton Ave, Toronto Ontario M5R 0A6

T 416 253-9769 clinic@deerfields.ca

Typical agenda:

  • Part I: 6 pm – 8 pm
    • Guided meditation 20 min
    • Circle discussion how to apply mindfulness to everyday life 60-90 min
    • Break 10 min (beginners stay for part 2)
  • Part II: 8 pm- 9 pm
    • Introduction to new or review old meditation skill 20 min
    • Circle discussion how to apply new skill to everyday life 20 min
    • Guided meditation 20 min

[1] See recent US presidential elections

[2] Tawakol A, Ishai A, Takx RAP, et al. Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study. Lancet 2017; DOI:10.1016/S0140- 6736(16)31714-7. Abstract

[3] Alterations in Resting-State Functional Connectivity Link Mindfulness Meditation With Reduced Interleukin-6: A Randomized Controlled Trial. Biological Psychiatry. Jul 2016 Full Article

[4] Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework. Curr Cardiol Rep 2015 Dec. Full article

[5] Blumenthal JA, Sherwood A, Smith PJ, et al. Enhancing cardiac rehabilitation with stress management training: A randomized, clinical efficacy trial. Circulation 2016; 13:1341-1350. Article

Dr. Randy Knipping
Dr. Randy Knipping, Deerfields
randymch@sitedudes.com

Dr. Knipping has over 25 years of experience in clinical practice ranging from aerospace, emergency, forensic, occupational, preventive and integrative medicine.