Chronic stress increases heart inflammation, heart attacks and strokes

Decades ago, Hans Selye — the father of research on the General Adaptation Syndrome — explained the possible mechanism linking stress, the negative effects of adrenocortical hormones and cardiovascular risk, salute.eu writes.

He had identified the cardiotoxic activity of cortisol and catecholamines (adrenaline and noradrenaline) as the main drivers of the processes leading to hypertension and heart attacks.

Now, science is adding new pieces to the puzzle regarding the link between stress (often accompanied by economic and social difficulties) and heart disease.

Studies reveal that chronic inflammation — stemming from stress linked to socioeconomic status and lifestyle — is associated with specific structural changes in the heart, as well as with an increased risk of heart attack and stroke.

Moreover, these changes can appear long before the onset of cardiovascular symptoms, thus presenting a latent threat to health.

Disturbing data

The study analysed data from UK Biobank relating to almost 480,000 adults in the United Kingdom.

The researchers examined blood tests to assess inflammation, cardiac imaging and genetic data, combining the results.

The findings showed that individuals with the highest levels of inflammation (specifically, those in the top fifth of the population for these markers) faced a 43% higher risk of heart attack and stroke compared with those in the bottom fifth.

Moreover, the most pronounced signs of inflammation were linked to greater structural changes in the heart — such as thickening of the heart walls, a reduction in the size of the chambers and impaired filling — which can pave the way for heart failure.

Finally, higher levels of inflammation were linked to indicators of socioeconomic disadvantage and psychological distress, in addition to known risk factors such as smoking and excess body fat.

In short, chronic inflammation may be one of the biological pathways through which the stress of everyday life — including poverty and mental health problems — exerts biological effects that increase cardiovascular risk.

Greater attention to inflammation

Chronic inflammation can be seen as an activation of the immune system that is almost invisible, but persistent and, above all, long-term.

It has been linked to various diseases, including cancer and diabetes, and is increasingly recognised as an underlying cause of heart disease.

Stress seems to act, in a way, as fuel for this reaction.

“Chronic inflammation is complex, but we know that it is linked to our health and is influenced by a range of factors related to lifestyle and socio-economic status; this means that people may be at higher risk simply because of their environment, economic status, family health and lifestyle,” noted Declan O’Regan, British Heart Foundation Chair of Cardiovascular Artificial Intelligence at Imperial College London.

“Our study — the largest of its kind — suggests that millions of people may be living with low-grade inflammation, which is slowly changing their heart and causing long-term damage, thereby increasing the risk of heart attack and stroke,” he added.