By James M. Rippe

High stress levels constitute one of the cardiac health risks (and general health risks) that everyone faces daily. In fact, a growing body of scientific and medical evidence links stress to a variety of illnesses ranging from heart disease and cancer to the common cold. Unfortunately, stress is pervasive in today’s modern, fast-paced society.

One study from the National Institute of Mental Health found that more than 30 percent of adults experience enough stress in their daily lives to impair their performance at work or at home.

Defining stress

Despite literally hundreds of studies about stress, a precise definition is frustratingly difficult to come up with. Perhaps the best simple definition came from Canadian scientist Hans Selye, who in 1956 defined stress as “the nonspecific response of the body to any demands made on it” in his pioneering book The Stress of Life.

The demand (the thing that stresses you out, be it a traffic jam, power outage, or deadline) and the response (your internal reaction to, say, a $2,000 car-repair bill or any other demand) are the key components of stress. No doubt you’re faced with many demands (stressors) every day. How you respond is up to you, but remember that the way you respond can contribute either to improved cardiac health or to increased cardiac risk.

Describing positive versus negative stress

Many people don’t realize that having positive stress is possible. But a certain amount of stress may be necessary for you to reach your optimal performance. For example, outstanding athletes often perform at their best in the “big game.”

And you may be one of the many people who work best when faced with a deadline. However, when stress becomes excessive or when your response to the stress becomes negative, your health in general, and your cardiac health in particular, may be harmed.

Linking stress to heart disease

When it comes to the heart, stress can

  • Increase your likelihood of developing coronary heart disease (CHD)

  • Create chest discomfort that can mimic heart disease

  • Cause palpitations or even very serious arrhythmias

  • Contribute to the development of high blood pressure

Numerous scientific studies link job-related stress to an increase in the likelihood of your developing coronary heart disease. Some of these studies show that heart attacks occur more often during the six months following negative life changes, such as divorce, financial setback, or the death of a spouse or close relative than they do during the six months before these negative life changes.

Linking stress to high blood pressure

The link between stress and high blood pressure is well established. Many years ago, Dr. Walter Cannon, a famous physiologist, coined the phrase fight or flight to describe the physiological changes that occur during stress. He linked this response to the genetic makeup of humans.

When confronted by a dangerous and frightening saber-toothed tiger, for example, ancient human ancestors needed to make an immediate decision whether to stand and fight, freeze with fear, or immediately take flight. One physiological response to this stress is elevated blood pressure.

Unfortunately, people still have the genetic makeup that causes their blood pressure to rise during emotionally stressful situations. For example, studies show that air-traffic controllers, whose jobs place them under continually high levels of stress, are more likely to have high blood pressure than people in many other professions.

Constant pressure caused by events and situations over which you feel you have only minimal control is a particularly dangerous form of stress. For example, blood pressure rises in soldiers during times of war, in civilians faced with natural disasters, such as floods or explosions, and in entire societies in which social order is unstable.

Linking Type A personality traits to heart problems

About 50 years ago, Dr. Ray Rosenman and Dr. Meyer Friedman developed the concept of Type A Personality, which links certain kinds of behavior and personality traits with an increased incidence of heart attack. Unfortunately, the concept of Type A behavior often is loosely and incorrectly applied to any hard-driving, busy worker.

The research defines Type A behavior, however, as containing aggression, competitiveness, and hostility. Individuals who exhibit true Type A behavior also are likely to have a sense of incredible urgency as they attempt to accomplish poorly defined goals in the shortest period of time.

Likewise, they often are angry when confronted with unexpected delays. The combination of frustration and anger is essential to manifest the cardiac danger associated with a Type A personality. Hard workers who are happy in their work, even when they’re workaholics, are more likely to fall into what Rosenman and Friedman characterized as Type B personalities and are not at increased risk of heart disease.

Linking anger to dangerous heart problems

More recent studies from a variety of investigators, including Dr. Redford Williams at Duke University, show that the hostility component of Type A behavior specifically accounts for almost all the increased risk of cardiac disease.

Using one of the subscales on psychological inventories administered to many participants in large heart-health trials, Dr. Williams and his colleagues identified cynical mistrust of others, frequent experience of angry feelings, and overt expression of cynicism and anger in aggressive behavior as key factors that make up the psychological profile that increases the risk of developing heart disease.

In real-life situations, this discovery points not only to the knowledge that anger kills when you let it control your behavior — think road rage — but also to the knowledge that it may also kill by damaging your heart.