The holiday season is in full swing, and with the warmth, joy, camaraderie, and love comes the inevitable stress…the overeating, emotional overload, financial pressures, and inflated expectations. Cardiologists warn that emotional stress combined with poor health habits can make the holiday season hard on your heart.

“From a practical point of view, often people overindulge in food and drink during the holiday season,” pointed out Paul Moulinie, MD, Chief of Cardiology at Huntington Hospital. “Straying from a healthy diet and slacking off on exercise can have a negative impact on cardiac function.”

Beyond that, emotional stress which can be present all year long may be exacerbated during the holidays. And symptoms of emotional stress can not only impair recovery from cardiac episodes, but can also play a major role in causing heart disease, according to attending cardiologist Ramanjit Bagga, MD. Consider the following:

Paul Moulinie, MD

Ramanjit Bagga, MD

Studies have shown that 15 percent of cardiac patients show symptoms of major depression — this rate is three times higher than what is observed in the general population.

Another 15 – 20 percent of cardiac patients show symptoms classified as borderline depressive.

Thirteen percent of cardiac patients will have a recurrence of their disease; that rate jumps to 26 percent among cardiac patients who are depressed.

Depression works in subtle ways to increase an individual’s risk of developing heart disease. For instance, depressed people are less likely to exercise and more likely to seek comfort in unhealthy food choices, and are consequently more likely to suffer from obesity, a major risk factor for cardiac disease. Depression negatively impacts behavior in other ways as well. It is linked to an increase in smoking and decreased compliance with medication recommendations, according to Dr. Bagga.

Researchers have also linked depression to physiological changes. For example, depression can cause endothelial dysfunction, a condition in which the arteries are more susceptible to plaque buildup. It can cause increased platelet activity, where the blood cells become more sticky, promoting the progression of plaque.

“Depression is also known to increase inflammatory markers, which increases the likelihood
of developing atherosclerosis,” said Dr. Bagga.

Depression is linked to a 60 percent increase in the likelihood of developing metabolic syndrome, a combination of conditions including diabetes, elevated triglycerides, and obesity that has been linked to heart disease.

“Cardiac research is still primarily focused on quantity of life rather than quality of life,” noted Dr. Bagga. “However a number of trials have begun to evaluate depression in cardiac patients.”

Within Huntington Hospital, the nursing staff aggressively monitors patients for depression and intervenes when appropriate, according to Dr. Moulinie.

“Particularly on the Cardiac Services units, our nurses are acutely aware of the deleterious effects of stress and depression surrounding a cardiac illness,” Dr. Moulinie emphasized. “It is not unusual for psychiatric or social work consultations to be requested for patients on monitored units, and patients’ family, friends and clergy are often recruited to soften the impact of a procedure, diagnosis or prognosis.”

Healthcare professionals in the hospital’s Center for Complementary Care are available to assist patients with stress management strategies, and to offer massage, aromatherapy, and other complementary techniques.

“The more we learn, the more apparent it becomes that finding effective ways to manage stress is important not only for the mind but also for the body,” said Dr. Moulinie.

So this holiday season, take time to manage stress and emotions. It may be the most important gift you can give yourself and your heart. //

Healthline December 2008