DEAR MAYO CLINIC: I’ve heard that all the stress of the holidays can lead to a heart attack. What’s the link, and what can I do to reduce my risk?
ANSWER: It’s easy to get caught up in the stress and chaos that accompany the holiday season. For some women, their busy lives become even more hectic, and the result can be overwhelming. Also, women often ignore the symptoms of heart disease.
Heart disease is the No. 1 killer for women and men. More women die of heart disease than of breast cancer. Taking care of your heart health involves avoiding risk factors or behaviors that contribute to heart disease, recognizing symptoms, and seeking treatment.
Risk factors for heart disease
Traditional risk factors for coronary artery disease include high cholesterol, high blood pressure, smoking tobacco and obesity. However, nontraditional risk factors, such as stress, anxiety and depression, also affect heart health.
People often underestimate the negative effects that psychosocial stress can have on their heart health. Psychosocial stressors are life situations that cause unusual or intense stress, such as divorce, family conflicts, death of a loved one, prolonged illness or a natural catastrophe.
Studies have shown that depression and psychosocial stress are associated with heart attacks. High stress levels also have been shown to negatively affect health recovery after a heart attack. It’s important to address both traditional and nontraditional risks for heart disease and recognize that they affect men and women differently.
How does stress lead to heart attacks?
Psychosocial stress can be short-term or long-term, and both types have been associated with heart disease. Exactly how stress leads to a heart attack is still being studied.
Emotional stress can lead to an increase in blood pressure, or hypertension, which subsequently leads to heart disease and plaque buildup in the coronary arteries. Emotional stress also can lead to increased levels of stress hormones, or cortisol.
These hormones affect platelets and autonomic tone, which is how your body controls involuntary functions such as heart rate and blood pressure. All these factors play a role in heart disease.
Stress can also lead to unhealthy mechanisms for coping with stress, such as stress eating or substance abuse, and not exercising, which in turn can lead to heart disease.
Short-term, extremely stressful situations can cause severe but usually temporary heart failure. This condition is called broken heart syndrome, also known as takotsubo cardiomyopathy, apical ballooning syndrome or stress cardiomyopathy.
What are the risk factors for heart disease in women?
Women of all ages should take heart disease seriously. Women under 65, and especially those with a family history of heart disease, need to pay close attention to heart disease risk factors. These include:
- Diabetes.
- Mental stress and depression.
- Smoking.
- Inactivity.
- Alcohol consumption.
- Menopause, due to low levels of estrogen and developing menopause before 40.
- Pregnancy complications, such as high blood pressure or diabetes, or even premature delivery.
- Inflammatory diseases, such as rheumatoid arthritis or lupus.
What are heart disease symptoms in women?
Women and men are equally likely to experience chest pain, pressure or discomfort. But women are more likely to have other associated symptoms, including:
- Neck, jaw, shoulder, upper back or abdominal discomfort.
- Shortness of breath.
- Pain in one or both arms.
- Nausea or vomiting.
- Sweating.
- Lightheadedness or dizziness.
- Unusual fatigue.
If you experience chest pain with the symptoms mentioned above, call 911 right away.
Managing holiday stress
For many women, the holiday season brings the most cherished moments in their lives, but it also can be among the most stressful times of the year. Often this is because people carry expectations influenced by memories and societal pressures ― a smiling, happy family photo on holiday cards, the smell of grandma’s home cooking at Hanukkah, seeing a Christmas tree lit or singing your favorite Kwanzaa song.
These sights, smells and sounds of the season become measures of happiness and satisfaction. However, these visions don’t always match reality, and that can lead to stress.
At any time, but especially during the holidays, the key to coping is setting realistic expectations. Take a few moments as a family to write down what would make the holidays an enjoyable time with those you love. And let go of the things that add stress and no joy.
Other lifestyle changes that can help curb stress during the holidays and throughout the year include:
- Increase physical exercise.
- Practice relaxation exercises.
- Make a connection to your spirituality.
- Seek professional help.
- Eat a healthy diet.
- Limit alcohol.
- Stop smoking.
- Monitor your heart health.
Niti Aggarwal, M.D., is a cardiologist in Mankato and Rochester, Minnesota.
