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Study of An Old Problem Arrives at New Conclusions About Heart Disease

(HealthDay News) -- The more health researchers learn about stress, the more they confirm its bad effect on humans. Too much stress in one’s life has been found to be a contributing factor to diseases and conditions ranging from heart disease to cancer, from Crohn’s disease to diabetes.

Scientists have increasingly been combining various emotional factors in a person’s life in studies to see if they can zero in on what causes what the most intensely; e.g., can “holding in” (internalizing) one's emotions actually bring on physical illness?

One conclusion, so far: Men, more than women, may need to learn to relax if they want to avoid heart disease. That's what a study found about men who come from families with a history of early cardiac problems. They, themselves, were diagnosed themselves with heart disease 12 years earlier than men without a family history of the disease. The researchers also found that men with a family history scored significantly higher on a stress symptoms checklist.

"It turned out that crankiness, particularly as rated by a spouse, was a strong predictor of early family history and of heart disease themselves in males," says study author Mark Ketterer, a clinical psychologist at Henry Ford Hospital in Detroit.

The researchers asked 100 men and women between the ages of 29 and 73 who had already been diagnosed with heart disease about the health of their family members and their own medical history. They were also examined and had their blood pressure, cholesterol and weight checked. Then the study volunteers completed a 58-item questionnaire, dubbed the Ketterer Stress Symptom Frequency Checklist, designed to measure aggravation, irritation, impatience, anger, depression and anxiety. Spouses of 38 of the male volunteers were also asked to complete the checklist, because Ketterer says men often deny these symptoms.

The researchers found that women with a history of early heart disease in their families were diagnosed with their own heart disease two years earlier than people without the early family history, compared to 12 years for men in similar situations. Early heart disease occurs before 56 years of age. Ketterer says the findings for women were not statistically significant.

None of the standard risk factors for heart disease, such as high blood pressure, elevated cholesterol, smoking or obesity was significantly different between the groups. What did stand out, according to Ketterer, were the stress scores for men.

"This study provides evidence that the propensity to a cranky personality is heritable," says Ketterer. "About 40 percent of the degree of your crankiness is in your genes, and early heart disease might be accounted for by that factor."

"Controlling stress is every bit as important as controlling cholesterol or hypertension, and may even be somewhat more important [for men with a family history of early heart disease], according to our results," Ketterer says.

Another important finding, he says, is that people don't tend to perceive themselves as stressed, angry or cranky, even though others see them that way. So Ketterer suggests that doctors ask patients' spouses about their personalities to get a better assessment of their stress level.

Controlling stress may be one way to help prevent heart disease, which is why it's part of many cardiac rehabilitation programs, says Dr. Stephen Siegel, a cardiologist at New York University Medical Center. However, he says to assume that the reason people in certain families share a predisposition to early heart disease is solely because of stress is "a little bit presumptuous." He adds there are many complex factors that lead to heart disease, and stresses this study was very small in size. The study was first presented March 6, 2003 at the annual meeting of the American Psychosomatic Society in Phoenix.

Siegel also says researchers haven't pinpointed whether it's stress that may increase the risk of heart disease, or the behavioral changes that occur because someone is stressed.

"People who are stressed tend to smoke more and eat more," which, Siegel says, could increase heart disease risk.

While scientists continue to debate the role of stress in heart disease, Siegel says it's a good idea to reduce your stress levels and to control all of the other risk factors for heart disease -- don't smoke, maintain a healthy weight and exercise regularly.

On the Web

This article from the Texas Heart Institute looks at stress and other heart disease risks.

SOURCES: Mark Ketterer, Ph.D., clinical psychologist, department of behavioral health, Henry Ford Hospital, Detroit; Stephen Siegel, M.D., cardiologist and clinical assistant professor, medicine, New York University School of Medicine and Medical Center, New York City; March 6, 2003, presentation, American Psychosomatic Society, annual meeting, Phoenix
Publication date: June 1, 2006
Author:Serena Gordon, HealthDay Reporter
Copyright © 2006 ScoutNews, LLC. All rights reserved.


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