Friday, August 13, 2010

Stress as a Major Cardiac Risk Factor

Is stress a major cardiac risk factor?  I have a wager based on this one, so let's review the evidence.  The term stress was first used in a biological context by endocrinologist Hans Selye who famously proposed that there is both good stress (eustress) as well as bad stress (distress).  Okay, thank you Hans.  The Heart and Stroke Foundation lists stress as one of 13 risk factors, which doesn't exactly make it a "major" one.  The American Heart Association lists stress under "other factors" - not "major factors" in their list of 12 contributors to cardiac risk.  And the Expert Working Group of the National Heart Foundation of Australia (who specifically reviewed the evidence I seek) reported in 2003 that: "there is no strong or consistent evidence of an independent causal association between ... work-related stressors ...and coronary heart disease (CHD)."  However, their study goes on to say: "the increased risk contributed by these psychosocial factors is of similar order to the more conventional CHD risk factors such as smoking, dyslipidemia and hypertension" - all of which are acknowledged universally as major cardiac risk factors!  So which is it, boys?  Mind you that was then and (Buddha knows) the world is a lot more stressed out these days.  So, I think I win.  I just haven't been able to find the evidence in print.  Okay, it's a draw.