In honor of February being Heart Month, Hotline will feature stories and studies related to the heart.
“This is making my blood pressure rise.” While one-liners about stress and its impact on health – particularly the heart – are commonplace, exactly how stress affects the body is still not fully understood. For the first time, an MGH study has identified a link between activity in one part of the brain to episodes in the heart.
Here, Ahmed Tawakol, MD, associate director of Nuclear Cardiology and co-director of the MGH Cardiac MR PET CT Program and the lead author of the study published in The Lancet, explains his findings.
Why is this important?
This research – for the first time in humans – links brain activity to subsequent cardiovascular disease.
People who had more activity in the amygdala – the area of the brain determining fear, stress and emotion – were also more likely to suffer from heart disease in the future – mostly heart attack and strokes.
What teams were involved in the study?
We carried out two complementary studies.
The first, here at MGH, analyzed about 300 people who had PET/CT imaging, mostly for cancer. The scans recorded brain activity, bone marrow activity, spleen activity and inflammation in the heart arteries. We were interested in the bone marrow and the spleen because some animal studies have suggested stress can lead to more immune cell production in those areas. After that, we closely followed the health of each patient for about two to five years.
The second study, by the Icahn School of Medicine at Mount Sinai in New York, enrolled 13 people with a history of post-traumatic stress disorder. They were evaluated for their current levels of perceived stress and they had scans to measure amygdala activity and arterial inflammation.
What did you find – and did anything surprise you?
This is where things became interesting. During that two- to five-year period in which we were watching patients at the MGH, 22 of the patients had a cardiovascular event – such as a heart attack, stroke, chest pain or heart failure. In looking at the initial brain scans of those 22 patients, we found a higher level of stress activity in the amygdala.
The link was strong, even when taking into account other factors like smoking, lipids, diabetes or hypertension. The folks with higher activity in the amygdala developed heart attacks and strokes sooner than those who showed lower activity. The sub-study from Mount Sinai showed that the subjects’ psychosocial stress level – assessed using a stress questionnaire – went hand-in-hand with amygdalar activity – measured with imaging.
While smaller stress reduction studies have been promising, large trials are still needed to confirm that treating stress actually reduces heart attacks. In the meantime, it’s reasonable to recommend stress reduction techniques to patients with higher stress and a higher risk of heart disease. Controlling stress should enter the conversation, along with diet and exercise, when it comes to combating cardiovascular disease.
Mark your calendars: February is Heart Month. Here at the MGH there are a number of events happening hospitalwide.
Friday, Feb. 3 – Go Red for Women
Don’t forget to wear red to raise awareness of heart disease in women. Snap a selfie and share it on social media. Be sure to tag #GoRedWearRed, #BostonGoesRed and#MassGeneral.
Thursday, Feb. 9 – Heart health tips in the White Lobby
Come between 11 am-1 pm to the White Lobby for a spin of the Heart Disease Risk Factor Wheel, along with fun giveaways from the Heart Center.
Thursday, Feb. 9 – Prevention focus in the Blum Center
Nandita Scott, MD, of Cardiology, will discuss the differences between men’s and women’s hearts in the Blum Center from noon-1 pm, with a focus on prevention of heart disease.
Friday, Feb. 24 – Shared decision making on heart disease
Rory Weiner, MD, MGH cardiologist, will answer questions about heart disease from noon-1 pm in the Blum Center.
Read more articles from the 01/27/17 Hotline issue.