10 Facts about A [little] Fib that May Surprise You

Atrial fibrillation, also called AF or AFib, is the most common type of heart rhythm disorder. People with this condition are at higher risk for serious medical complications, such as dementia, heart failure, stroke, or even death. Too many of those affected by the condition don’t realize that they have it, and many who have it don’t realize the seriousness of the affliction. All too often, healthcare providers may also minimize the effects of the condition.

September is Atrial Fibrillation Awareness Month, designated to help patients and healthcare providers learn more about this complex condition. In addition to stroke prevention, additional know-how can improve the overall wellness of those suffering from AFib. Often, those with AFib have a lower quality of life than those who have suffered a heart attack. And, unfortunately, some healthcare providers may not know about treatment options that can essentially put a stop to the condition.

For those who have AFib, seeking information about the ailment and  finding early treatment are imperative. The longer someone has AFib, the more likely they will convert from intermittent AFib to enduring it all the time, making it much more difficult to stop or cure.

What is atrial fibrillation?

Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications.  A racing, pounding heartbeat that happens for no apparent reason should not be ignored, especially when other symptoms are also present — like shortness of breath with light physical activity or lightheadedness, dizziness, or unusual fatigue. AFib occurs when the heart muscles fail to contract in a strong, rhythmic way. When a heart is in AFib, it may not be pumping enough oxygen-rich blood out to the body.

Why is AFib associated with a five-times-greater risk for stroke?

When the heart is in AFib, the blood can become static and can be left pooling inside the heart. When blood pools, a clot can form. When a clot is pumped out of the heart, it can get lodged in the arteries which may cause a stroke. Blocked arteries prevent the tissue on the other side from getting oxygen-rich blood, and without oxygen the tissue dies.

Any person who has AFib needs to evaluate stroke risks and determine with a healthcare provider what must be done to lower the risks. Studies show that many people with AFib who need risk-lowering treatments are not getting them. Learn more about stroke risks with the CHA2DS2–VASc tool.

If I don’t have these symptoms, should I be concerned?

There are people who have atrial fibrillation that do not experience noticeable symptoms. These people may be diagnosed at a regular check-up or their AFib may be discovered when a healthcare provider listens to their heart for some other reason.

However, people who have AFib with no symptoms still have a five-times-greater risk of stroke. Everyone needs to receive regular medical check-ups to help keep risks low and live a long and healthy life.  Many may experience one or more of the following symptoms:

  • General fatigue
  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • Dizziness
  • Shortness of breath and anxiety
  • Weakness
  • Faintness or confusion
  • Fatigue when exercising
  • Sweating
  • Chest pain or pressure

Are there different types of AFib?

The symptoms are generally the same; however, the duration of the AFib and underlying reasons for the condition help medical practitioners classify the type of AFib problems.

  • Paroxysmal fibrillation is when the heart returns to a normal rhythm on its own, or with intervention, within 7 days of its start. People who have this type of AFib may have episodes only a few times a year or their symptoms may occur every day. These symptoms are very unpredictable and often can turn into a permanent form of atrial fibrillation.
  • Persistent AFib is defined as an irregular rhythm that lasts for longer than 7 days. This type of atrial fibrillation will not return to normal sinus rhythm on its own and will require some form of treatment.
  • Long-standing AFib is when the heart is consistently in an irregular rhythm that lasts longer than 12 months.
  • Permanent AFib occurs when the condition lasts indefinitely and the patient and doctor have decided not to continue further attempts to restore normal rhythm.
  • Nonvalvular AFib is atrial fibrillation not caused by a heart valve issue.

Over a period of time, paroxysmal fibrillation may become more frequent and longer lasting, sometimes leading to permanent or chronic AFib. All types of AFib can increase your risk of stroke. Even if you have no symptoms at all, you are nearly 5 times more likely to have a stroke than someone who doesn’t have atrial fibrillation.

How are heart attack symptoms different from AFib symptoms?

Fluttering and palpitations are key symptoms of AFib and are the key differences, but many heart problems have similar warning signs. If you think you may be having a heart attack, DON’T DELAY. Get emergency help by calling 9-1-1 immediately. A heart attack is a blockage of blood flow to the heart, often caused by a clot or build-up of plaque lodging in the coronary artery (a blood vessel that carries blood to part of the heart muscle). A heart attack can damage or destroy part of your heart muscle. Some heart attacks are sudden and intense — where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.

People living with AFib should know the Warning Sings

As stated earlier, having atrial fibrillation can put you at an increased risk for stroke. Here are the warning signs that you should be aware of:

Heart Attack Warning Signs

Chest Discomfort

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in Other Areas of the Upper Body

Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of Breath

With or without chest discomfort.

Other Signs

May include breaking out in a cold sweat, nausea or lightheadedness.

Stroke Warning Signs

Spot a stroke F.A.S.T.:

  • Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile.
  • Arm Weakness : Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech Difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue.” Is the sentence repeated correctly?
  • Time to call 9-1-1: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

Call 9-1-1 immediately if you notice one or more of these symptoms, even if they are temporary or seem to disappear.

10 ATRIAL FIBRILLATION FACTS THAT MAY SURPRISE YOU

  1. AFib affects lots of people.  Currently as many as 5.1 million people are affected by AFib — and that’s just in America. By 2050, the number of people in the United States with AFib may increase to as many as 15.9 million. About 350,000 hospitalizations a year in the U.S. are attributed to AFib.  In addition, people over the age of 40 have a one in four chance of developing AFib in their lifetime.
  2. AFib is a leading cause of strokes.  Nearly 35 percent of all AFib patients will have a stroke at some time. In addition to leaving sufferers feeling weak, tired or even incapacitated, AFib can allow blood to pool in the atria, creating blood clots, which may move throughout the body, causing a stroke. To make matters worse, AFib strokes are fatal nearly three times as often as other strokes within the first 30 days. And according to a recent American Heart Association survey, only half of AFib patients understand that they have an increased risk of stroke.
  3. The U.S. Congress recognizes the need for more AFib awareness. StopAfib.org, along with several other professional and patient organizations, asked Congress to make September AFib Month. On September 11, 2009, the U.S. Senate declared it National Atrial Fibrillation Awareness Month.
  4. Barry Manilow has AFib. In 2011, Manilow spoke to Congress about AFib, urging the House of Representatives to pass House Resolution 295, which seeks to raise the priority of AFib in the existing research and education funding allocation process. The resolution does not seek any new funding. Other celebs with AFib include NBA legends Larry Bird and Jerry West, politicians George H. W. Bush and Joe Biden, Astronaut Deke Slayton, Billie Jean King, music mogul Gene Simmons and Helmut Huber, the husband of daytime TV star Susan Lucci.
  5. Healthcare professionals often minimize the impact of AFib on patients.  According to recent research in the Journal of Cardiovascular Nursing, “Compared with coronary artery disease and heart failure, AFib is not typically seen by clinicians as a complex cardiac condition that adversely affects quality of life. Therefore, clinicians may minimize the significance of AFib to the patient and may fail to provide the level of support and information needed for self-management of recurrent symptomatic AFib.”
  6. AFib patients may go untreated.  AFib can fly under the radar as some patients don’t have symptoms and some may only have symptoms once in a while. Thus, patients may go for a year or two undiagnosed, and sometimes not be diagnosed until after they have a stroke or two. Because some health care professionals perceive that AFib doesn’t affect patients’ everyday lives, a common approach is to just allow patients to live with the condition. But…
  7. The quicker the treatment, the greater the chance AFib can be stopped.  For those who have AFib, information about the ailment and treatment options are imperative. The longer someone has AFib, the more likely they will convert from intermittent to constant AFib, which means it’s more difficult to stop or cure.
  8. AFib changes the heart.  Over time, AFib changes the shape and size of the heart, altering the heart’s structure and electrical system. Research at the University of Utah shows that this scarring (fibrosis) from long-term remodeling is correlated with strokes.
  9. Treatments continue to rapidly evolve.  For years, the standard treatment for AFib patients was to send them home with medications, some of which caused harm. Now there are additional options for stopping AFib, including minimally invasive ablation procedures performed inside and outside the heart. For stubborn and long-lasting AFib, open-heart surgery may provide a cure.
  10. You can make a difference in an AFib patient’s life.  This month, forward a link to someone you may know who could have the condition. Attend an AFib awareness raising event or webinar. Or share StopAfib.org siteand ALittleFib.org with patients and friends.  Something as simple as that can help someone become free of AFib.

Prevention and Risk Reduction

Although no one is able to absolutely guarantee a stroke or a clot is preventable, there are ways to reduce risks for developing these problems.

After a patient is diagnosed with atrial fibrillation, the ideal goals may include:

  • Restoring the heart to a normal rhythm (called rhythm control)
  • Reducing an overly high heart rate (called rate control)
  • Preventing blood clots (called prevention of thromboembolism)
  • Managing risk factors for stroke
  • Preventing additional heart rhythm problems
  • Preventing heart failure

Getting Back on Beat

Avoiding atrial fibrillation and subsequently lowering your stroke risk can be as simple as foregoing your morning cup of coffee. In other words, some AFib cases are only as strong as their underlying cause. If hyperthyroidism is the cause of AFib, treating the thyroid condition may be enough to make AFib go away.

Doctors can use a variety of different medications to help control the heart rate during atrial fibrillation.

“These medications, such as beta blockers and calcium channel blockers, work on the AV node,” says Dr. Andrea Russo of University of Pennsylvania Health System. “They slow the heart rate and may help improve symptoms. However, they do not ‘cure’ the rhythm abnormality, and patients still require medication to prevent strokes while remaining in atrial fibrillation.”

AFib Treatment Saves Lives & Lowers Risks

If you or someone you love has atrial fibrillation, learn more about what AFib is, why treatment can save lives, and what you can do to reach your goals, lower your risks and live a healthy life.

If you think you may have atrial fibrillation, here are your most important steps:

  1. Know the symptoms
  2. Get the right treatment 
  3. Reduce risks for stroke and heart failure

Finding the right physician who gets your AFib, understands all the options for treatment, and will openly collaborate with you in your care is key.  Use our first of its kind healthcare ecosystem to find one near you.

As a patient, you can take control of your healthcare.  Go to HealthLynked.com, right now, to sign up for Free!

 

Sources:

Heart.org

Aug 29, 2012 | ArticlesDoctor’s Voice | 12  |

 

 

7 Health Benefits of Holding Hands and Its Potential for Healing Society


There’s something special about holding hands with another human being. All of us are innately conscious of how this simple act can stir an instant intimacy, heighten our awareness and express a deep connection. This alchemy of two hands touching has so deeply captured our collective imagination, it’s been the subject of our highest artistic achievements, from the ceiling of the Sistine Chapel, to the poetry of Romeo and Juliet, to the lyrics of the Beatles.

But what is it about holding hands, exactly, that makes it so powerful? In partnership with Dignity Health, The Huffington Post explored what science can tell us about this ubiquitous, mysterious gesture and how it can affect our brains and physical well-being, as well as our relationships. Holding hands, we learn, has the power to impact the world.

Holding Patterns

Human beings are hardwired to seek out each other’s touch before we are even born. If you’ve ever touched the palm of a newborn baby, then you’ve likely witnessed (and been treated to) one of the earliest instinctual responses to manifest in humans: the “grasping reflex.” Known to science as the palmar grasp reflex, the instinct makes a baby grab your finger and squeeze it tight.

Humans share this trait with our primate ancestors; it can still be observed in species of monkeys, notably in the way newborns cling to their mothers, unsupported, so the mother can transport the two, hands-free.

Human fetuses have been observed displaying this behavior weeks before full-term delivery. They will clutch their umbilical cord, place their hand in their mouth, or suck their thumb. Twin fetuses are known to hold hands, as poignantly captured in a Kansas family’s moving sonogram image, in which one twin is healthy and the other is critically ill.

Babies may relinquish the grasping reflex over time, but the importance and vitality of touch remain essential.

Touch, A Necessity Of Life

Quantifying the power of touch can be challenging for researchers — measuring the outcome of, say, depriving a child from human contact is unethical. But an unsettling episode in Romania offered scientists some telling insights into what can happen when we are denied the nurturing that touch can provide.

Charles Nelson, professor of pediatrics at Harvard Medical School and author of the book Romania’s Abandoned Children: Deprivation, Brain Development, and the Struggle for Recovery, led a study that measured the developmental progress of hundreds of children raised in poorly run Romanian orphanages. They had endured years without being held, nuzzled or hugged, according to a Harvard Gazette report. Many of the children had physical problems and stunted growth, despite receiving proper nutrition.

The same appears to hold true through adulthood. Adults who don’t receive regular human touch — a condition called skin hunger or touch hunger — are more prone to suffer from mental and emotional maladies like depression and anxiety disorders.

As psychologists Alberto Gallace and Charles Spence point out in the journal Neuroscience and Biobehavioral Reviews, “touch is the first of our senses to develop” and “our most fundamental means of contact with the external world.” It’s more than just a comforting sensation; touch is vital to human development and life.

The ‘Love Hormone’ 

Clearly, we humans live to touch. But how does it sustain us? What’s happening in our bodies and minds when what we touch is another person’s hand?

Multiple studies — including one conducted at the University of California Los Angeles (UCLA) — show that human touch triggers the release of oxytocin, aka “the love hormone,” in our brain. Oxytocin is a neurotransmitter that increases feelings of trust, generosity and compassion, and decreases feelings of fear and anxiety.

Dr. Tiffany Field, director of the Touch Research Institute (TRI) at the University of Miami/Miller School of Medicine, says that holding hands is one of the most powerful forms of touch in part because the skin is a sense organ and needs stimulation, just as the ears and the eyes do.

Touch is our most fundamental means of contact with the external world.

Psychologists Alberto Gallace and Charles Spence

“When the fingers are interlaced and someone is holding your hand, they’re stimulating pressure receptors [that trigger] what’s called vagal activity,” Field says. “When there’s pressure in the touch, the heart rate goes down, the blood pressure goes down, and you’re put in a relaxed state. When people interlace their fingers, they get more pressure stimulation than the regular way of holding hands.”

Physical touch — and especially holding hands — is commonly associated with “feeling good.” Which raises the question, is there more hand-holding can do for us?

With Touch Comes Toleration

As we’ve seen, humans are not only creatures of habit, we’re also creatures of comfort. We gravitate toward situations and people who make us feel as content and secure as possible.

In the scientific study “Lending A Hand,” neuroscientists from the University of Virginia and the University of Wisconsin studied the effect the simple act of a human touch has on people in stressful situations. In this case, the participants underwent the threat of electric shock. The researchers came to the conclusion that a “loving touch reassures.”

On a physiological level, participants were able to better cope with pain and discomfort when they were holding hands because the act of holding hands decreased the levels of stress hormones like cortisol in their body. In other words, if stress is contagious, apparently a feeling of calm is contagious, too.

The Societal Imprint Of Human Touch 

Scientific research correlates physical touch with well being in  several important areas of life. Multiple studies at TRI concluded physical touch can affect pain management, lower blood pressure, decrease violence, increased trust, build a stronger immune system, create greater learning engagement and enhance overall well-being.

TRI is mining the potential of touch through a range of current studies, including how massage may help premature babies to grow, and if it can reduce depression in pregnant women such that they’re less likely to deliver prematurely.

“If every preemie was massaged in the U.S.,” Field suggests, “in one year that would save about $4.8 billion in hospital costs, because on average they get out of the hospital six days earlier.”

Field and her colleagues at TRI treat people with hip pain, typically from arthritis, and work to reduce depression and sleep problems in veterans who suffer from PTSD.  “Touch reduces pain because of the serotonin that’s released, and with the pressure on receptors during physical exercise, you get more deep sleep,” Field says.

Human Touch: More Important Now Than Ever

Science indicates that there’s a social argument to encourage hand-holding. What’s holding us back from embracing this? Today’s growing preoccupation with digital media over personal physical contact may unintentionally affect people negatively.

Though small in scope, another Touch Research Institute study suggests that American teenagers touch each other less than French teenagers do, and are more prone to aggressive verbal and physical behavior. Other data supports this claim that American youth is more violent and more prone to suicide than youth in other countries. Field’s hypothesis is that it has to do with ours being a “touch-phobic society.”

Oh please, say to me / You’ll let me be your man / And please, say to me / You’ll let me hold your hand

The Beatles, “I Wanna Hold Your Hand”

“With this taboo of touch in the school system, children are getting touched less,… less than when I was a kid, certainly,” Field says. “We’re so concerned about kids being touched the wrong way that we’ve basically banned it from the school system, and I think that’s really unfortunate.”

What can we do to shift this paradigm? It may be as simple as instilling in ourselves the mindfulness to outstretch a hand more often to those in our lives who matter most to us.

Here is a summary of seven documented benefits of holding hands:

  1. Holding hands is a great stress reliever

Holding hands with your significant other decreases the level of a stress hormone called cortisol. Even the touch of a friend or a teammate can make us feel more content, connected, or better about ourselves. When we are stressed out, a light touch on our hand can help ease the strain, both physically and mentally. Our skin also gets more sensitive when cortisol is rushing through our bloodstream, so the touch of a helping hand will have a significantly larger impact. The largest concentration of nerve endings is actually contained inside the hands and fingertips.

So, next time you’re having a really tough day, get together with your partner or a friend and ease the stressful day with them.

  1. Holding hands boosts love & bonding

Oxytocin is the hormone behind this benefit. Oxytocin strengthens empathy and communication between partners in a relationship, which is proven to be a contributing factor for long-lasting, happy relationships. Holding hands with your partner will improve your relationship and create a bond that will impact the quality of your relationship significantly.

Couples who have happy relationships hold hands automatically, sometimes without even noticing, because of a habit developed by their nervous systems. Holding hands produces the oxytocin, which makes us feel happier and more loved.

  1. Holding hands is great for your heart

Besides relieving stress, holding hands with your partner lowers your blood pressure, which is one of the major contributors to heart disease. When we’re clasping fingers with our loved ones, we’re not just easing stress and improving our relationships – we are providing a comfortable sensation that helps our heart. The power of a warm touch goes beyond the health benefits to the heart; a study from Behavioral Medicine backs up this claim.

  1. Holding hands relieves pain

While enduring pain, humans have the natural reflex to tighten their muscles. Think of childbirth – husbands are typically inside the delivery room holding their wife’s hand while she’s going through labor. The reflex to grasp our partner’s hand comes as second nature: It’s always easier to endure pain while holding hands with your soulmate.helping hand

  1. Holding hands fights fear

Remember that horrible scene in the last horror movie you saw that made you want to jump out of your chair? Luckily, your darling was with you to hold your hand and make you feel safe. The human brain responds to sudden stimulation using adrenaline; this stimulation gets our blood pumping and releases high levels of cortisol throughout our body.

During these moments, our natural reaction is to hold hands with someone we trust. It varies from person to person, but a large portion of women will instantly grab their partner’s hand. That’s the intuitive way to fight off nerve

  1. Holding hands provides a sense of security

Simple hand holding is a source of safety and comfort for young children. Remember when your parents taught you to how to cross the street or walked you down a crowded sidewalk? Or when you were learning to ride a bicycle? Insecurity disappears when we have a hand to hold and allows us to more easily conquer obstacles. The security that parents provide their children by holding hands shapes their children’s behavior and their way of thinking.

Additionally, the sensation of safety goes both ways; parents also feel safer when their children are within their grasp.

  1. Holding hands is just plain comfortable

Everybody loves comfort. The sensation of holding hands often provides a comfy feeling while talking a walk with your loved one. A great example is holding hands inside a jacket pocket to warm them up on those cold December nights when you decide to take a stroll in the snow with your partner. Even with gloves, we love to hold hands. It bonds us; it provides lovely sensations and gives us quality time with people we care about.

Conclusion

One thing is certain: our entire bodies, from our nerves to our brains, respond positively to touch and crave it from the time we’re born. Whether it’s due to instinct, comfort, intimacy or love, touch brings us closer to each other both physically and emotionally — and is a necessity for our overall well-being.

This tiny, commonplace behavior triggers chemical reactions in our minds that make us feel loved, happy, cared for, and respected.  Holding hands is one of the fundamental ways we can positively impact our lives and the lives of others.

When we hold hands, the nerves in our skin communicate with our core nervous system, producing hormones that make us feel pleasant and warm. There’s much more to it, of course, and new studies continue to explore the positive psychological effects of human touch today.



As AT&T used to say, “Reach out and Touch Someone”, but not through the phone.  Be present.  Put down the phone.  Hold hands.

Looking for a physician that understand the importance of compassionate care?  At HealthLynked, we are connecting patients and physicians in ways never before possible.  We have built a social ecosystem designed to bring you and your care givers closer than ever before to Improve HealthCare.

Ready to get Lynked?  Get connected today for free by going to HealthLynked.com.


Adapted from the following Sources:

By HuffPost Partner Studio.  The Science Behind The Profound Power Of Holding Hands |

A touching tribute. May 20, 2016

Kvrgic, Dejan.  Study Discovers 7 Surprising Benefits of Holding Hands.  LifeHack.com

 

 

 

Top Health News | Stress at Work Could be Harming Your Heart

Job strain could be harming your heart

Published
Individuals with high-strain jobs are more likely to develop atrial fibrillation, which is a common heartbeat disorder that can significantly raise the risk of stroke.

 

This was the conclusion of a new Swedish study on work stress, now published in the European Journal of Preventive Cardiology.

The researchers define “high-strain jobs” as those that are “psychologically demanding” but give job-holders little control “over the work situation.”

Examples include bus driving, nursing, and working on assembly lines.

Previous studies have linked work stress to coronary heart disease, but whether there is also a link to atrial fibrillation (A-fib) is less clear.

According to first study author Eleanor I. Fransson, who is an associate professor of epidemiology at Jönköping University in Sweden, A-fib “is a common condition with serious consequences and therefore it is of major public health importance to find ways of preventing it.”

A-fib and consequences

A-fib affects millions of people in the United States. It occurs when the upper two chambers of the heart (the atria) beat abnormally and disrupt blood flow to the lower two chambers (the ventricles).

The condition, which can be temporary or permanent, raises the risk of stroke. A person with A-fib has a four to five times higher risk of having a stroke than a person without it.

As well as irregular heartbeat, individuals with A-fib might also experience: chest pain, palpitations (a fluttering or pounding sensation in the heart), shortness of breath, feeling lightheaded, and “extreme fatigue.”

However, some people with A-fib may have no symptoms and not even realize that they have it.

Each year in the U.S., A-fib is responsible for over 750,000 hospital admissions and contributes to 130,000 deaths. Deaths in which A-fib is a contributory or primary cause have been increasing for the past 20 years.

The costs associated with A-fib are substantial. Overall, the burden in the U.S. amounts to $6 billion per year. The average annual medical bill for treating an individual with A-fib is $8,705 higher than for those without it.

Demands-control model

To assess work stress, Prof. Fransson and team used a measure of job strain that is based on the job demands-control model. It is one of the “most widely studied” models of work stress.

It is based on the idea that the effect of job demands on the strain that people experience is “buffered” by the amount of control that they have over their work.

For their study, the researchers used a Swedish questionnaire based on the model. It comprises five items on job demands and six on control.

The questions ask, for example, whether the individual:

  • has “to work very hard or very fast”
  • experiences conflicting demands in the job
  • has enough time to complete tasks
  • has to complete lots of repetitive tasks
  • is able to decide which tasks to do and how to do them

Link between job strain and A-fib

The researchers used data on 13,200 individuals who constituted a “representative sample of the working population” of Sweden. They were recruited in 2006, 2008, and 2010 to take part of the Swedish Longitudinal Occupational Survey of Health (SLOSH).

None of the participants had A-fib — or a history of the disorder — when they joined the study. Neither did they have a history of heart failure or heart attack.

They were all employed, and they all completed a battery of questionnaires when they entered the study. These were sent out by post and included the usual demographic questions plus others about health, lifestyle, and work.

The study followed the group for a median of 5.7 years. Using national registers, the researchers identified 145 cases of A-fib during this period.

Analysis of the SLOSH data — after adjusting for age, gender, and education — showed that job strain was linked to an almost 50 percent raised risk of A-fib.

The risk stayed the same when the team further adjusted the results to take into account the effect of exercise, smoking, blood pressure, and body mass index (BMI).

Stress, heart health, and the amygdala: Links explained

Published
That long-term stress is linked to cardiovascular disease is not breaking news. However, despite the well-known connection, exactly how the two are coupled has been difficult to pinpoint. Two studies published this week provide new insight.

 

Psychological stress carries with it a wealth of ills. In fact, excessive stress is known to contribute to a range of conditions, including hypertension (high blood pressure), ulcers, asthma, and irritable bowel syndrome.

It also has a well-documented impact on heart health. Some of this negative influence could be due to coping mechanisms – such as drinking alcohol or smoking tobacco – but there also appears to be a direct link between elevated stress levels and heart complaints.

Although this relationship is common knowledge to medical researchers and laypeople alike, the exact physiological processes behind it have remained difficult to unpick.

How can an emotion that is constructed in the brain influence the physical health of the heart?

While the link between stress and heart disease has long been established, the mechanism mediating that risk has not been clearly understood.”

Dr. Ahmed Tawakol, lead author

Studies in animals have found that stress increases the manufacture of white blood cells in bone marrow. This, in turn, leads to an increase in inflammation. How this fits into the full picture is yet to be understood.

Stress, inflammation, and heart health

Researchers from Massachusetts General Hospital (MGH) and Icahn School of Medicine at Mount Sinai (ISMMS) in New York designed a double-pronged investigation to gain insight into this fascinating question.

The results, published this week in The Lancet, provide new information regarding the links between cardiac health and psychological stress.

Dr. Tawakol’s paper describes two studies that aimed to combat the same problem in a similar way. The first study, conducted at MGH, analyzed positron emission tomograph (PET) and computed tomography (CT) scans of nearly 300 individuals. The scans utilized a radiopharmaceutical called fluorodeoxyglucose (FDG), which can simultaneously measure activity in the brain and the level of inflammation in arteries.

All participants were healthy at the time of the scan and had information in their medical records of at least three additional clinical visits within the following 5 years.

The second study was carried out at the Translational and Molecular Imaging Institute at ISMMS. This smaller study involved 13 participants with a history of post-traumatic stress disorder (PTSD). The researchers assessed their current levels of perceived stress and carried out FDG-PET scans.

In the larger MGH study, 22 participants experienced a cardiovascular event – such as stroke, angina, or a heart attack – during the follow-up period.

Dr. Tawakol and his team were able to show an association between the likelihood of a cardiac event and a specific part of the brain: the amygdala, a region known to be involved in emotional processing.

Stress and the amygdala

High levels of activity in the amygdala at the start of the study were associated with an increased risk of experiencing a cardiac event. Even after adjusting for other cardiovascular risk factors and atherosclerosis, the association was significant. The link became even stronger when the analysis only took into account more serious cardiac events.

They also showed that activity in the amygdala could predict the timing of the events. Higher levels of activity at baseline were associated with the occurrence of cardiac events sooner in time.

Greater activity levels in the amygdala were also associated with increased metabolism in regions of the body responsible for creating blood cells (bone marrow and spleen) and an increase in arterial inflammation.

The results from the smaller ISMMS study add weight to the MGH findings. Participants’ stress levels were, again, significantly associated with activity in the amygdala and arterial inflammation.

This pioneering study provides more evidence of a heart-brain connection, by elucidating a link between resting metabolic activity in the amygdala, a marker of stress, and subsequent cardiovascular events independently of established cardiovascular risk factors. We also show that amygdalar activity is related to increased associated perceived stress and to an increased vascular inflammation and hematopoietic activity.”

Zahi A. Fayad, Ph.D., co-senior author

Further research will help to deepen our understanding of the so-called amygdala-bone marrow-arterial axis. In the future, medications that target this mechanism may be useful for controlling or minimizing cardiovascular disease. The findings also underscore the importance of addressing stress in order to reduce health risks.

As Dr. Tawakol says: “It would be reasonable to advise individuals with increased risk of cardiovascular disease to consider employing stress-reduction approaches if they feel subjected to a high degree of psychosocial stress.”