It probably didn’t require another scientific study to convince most people that mental stress is not condusive to maintaining good heart-health.  Most experts were already certain of an association between mental stress and heart disease; however, a new study found that the link may be stronger in certain patients with existing heart problems.Mental stress, as a risk factor for death in heart patients, has been explored in previous studies at the University of Florida. In fact, one of those studies found that, for some heart patients, mental stress could be as significant a risk factor as smoking or elevated cholesterol levels.
Thus, the newest findings by a research team from the University of Florida are not only consistent with previous data, but are even more definitive with respect to those patients who already have coronary artery disease (CAD).
The researchers found that roughly one-third of the study subjects with CAD had decreased blood flow to the heart muscle (cardiac ishemia), while experiencing mental stress despite the fact that they had otherwise performed well on treadmill or chemical cardiac stress tests.
Cardiac ischemia, which deprives the heart of oxygen, is considered an indicator for future heart attack. It can be quite problematic for some patients since it may or may not be accompanied by chest pain.
According to Dr. David S. Sheps, one of the researchers: “We believe the phenomenon of mental-stress-induced reductions in blood flow to the heart is much more common than has been previously recognized.”
The study included fourteen men and seven women with CAD. Each had a recent negative stress test (within 6 months) result (treadmill or chemical).
Since the negative test indicated no decreased blood flow, there would be no reason not to consider these patients as having a positive prognosis.
Yet, when these subjects participated in a test geared toward detecting mental stress, 29% (6 of 21) demonstrated decreased blood flow without any chest pain.  The test involved having the subjects imagine a personally-unique stressful situation and then taking two minutes to prepare a four-minute speech describing it.
Blood pressure readings and electrocardiograms were taken at one minute intervals during the speech and for an additional 10 minutes after it was over. The researchers also preformed heart imaging scans to check for ischemia.
The findings supported the idea that mental stress works through a different mechanism than physical stress; however, the data gathered does not permit any real conclusions as to the clinical implications of reductions in blood flow related to mental stress.
The study is published in the March issue of the Journal of the American College of Cardiology.
Currently, while stress management is considered important to maintaining good overall health, groups such as the American Heart Association do not recognize mental stress as a contributing factor in heart disease. Thus, they are not yet prepared to recommend the use of stress management for the treatment of CAD.
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