stress + heart attack http://news.bbc.co.uk/1/hi/health/4754658.stm

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How stress triggers heart attack

Heart

It is known stress causes heart attacks but not exactly how

Scientists believe they have found some vital clues to how stress can

trigger a heart attack in vulnerable patients.

 

UK researchers focused on men who had suffered a heart attack or acute chest

pain triggered by stress.

 

They found evidence that stress can elevate blood pressure over an extended

period, and trigger the release of high levels of clot-forming platelets.

 

The University College London (UCL) study is published in Proceedings of the

National Academy of Sciences.

 

 

we can all help ourselves by recognising what stresses us out and coming up

with coping strategies to help control how we respond

British Heart Foundation

 

The UCL team looked at 34 men who had suffered a heart attack or severe

chest pain an average of 15 months earlier.

 

>From these they identified 14 whose symptoms had been preceded by acute

stress, anger and depression.

 

Stressful situations

 

The volunteers were given a series of stressful tasks to do, including

imagining stressful situations and making a speech.

 

Measurements were then taken of their blood pressure and chemistry.

 

In all men the blood pressure, heart rate and cardiac output increased in

response to the induced stress.

 

But in the group identified as particularly vulnerable to stress blood

pressure took longer to return to normal levels.

 

This group also recorded higher levels of platelets - the small blood cells

that form clots to stop bleeding - in their blood.

 

Lead researcher and Professor of Psychology for the BHF Andrew Steptoe said:

"What's been suspected for a number of years is that emotional stress can

trigger heart attack in people who are vulnerable.

 

"What this study does is to provide some information about the biology

underpinning that response and why it is that certain people may be

vulnerable.

 

"It is something to do with the way particular people react to emotional

stress."

 

He said the finding of high platelet levels was key.

 

Platelets clump together to stop bleeding when a tear occurs in the vessel

wall during a heart attack.

 

However, they in turn can cause a blockage in the heart which prevents the

blood from flowing in the heart.

 

Alison Shaw, a spokeswoman for the British Heart Foundation which funded the

study, said it provided vital clues into the biological reasons why stress

can trigger heart attacks.

 

'Ingenious'

 

"Currently, we can't easily tell whose bodies respond poorly to stressful

events, but we can all help ourselves by recognising what stresses us out

and coming up with coping strategies to help control how we respond to these

situations."

 

Dr Nick Brooks, president of the British Cardiac Society and consultant

cardiologist at South Manchester University Hospital NHS Trust, said the

study was ingenious but limited by the small numbers involved.

 

He said it showed that people with similar perceived levels of stress

responded in different ways.

 

"For those in whom stress provokes these major changes - they seem to be at

a greater risk of a coronary," he added.