Detox your heart


Section: Good Medicine | HEART HEALTH

Negative emotions like worry, frustration, and sadness can put you at risk of heart disease Learn how to protect your most vital organ

aS WOMEN we're blessed with rich emotional lives. We feel joys intensely, but we also take setbacks to heart — quite literally. Powerful negative emotions like depression, anger, and anxiety are more detrimental to our hearts than men's, says Mehmet Oz, M.D., cardio surgeon at NewYork — Presbyterian/Columbia University hospital and coauthor of You: Being Beautiful (Free Press, 2008). "Because men's hearts aren't as responsive to emotional stimuli, emotion is a more important predictor of heart problems in women," he says. "Hurtful emotions can cause a woman's arteries to spasm and close down like a boa constrictor squeezing around its prey."

THINK POSITIVE. Stressful emotions account for roughly 30 percent of all heart attacks, according to research from the landmark Interheart study, a survey of heart disease in 24,000 people in 53 countries completed in 2004. They rank on par with high blood pressure and abdominal fat, straining the heart by increasing your heart rate and flooding your body with high levels of potentially toxic hormones like cortisol and adrenaline. Stress from negative emotions also makes the blood clot faster, adding to heart disease risk. Stress can also play an indirect role in heart disease by interfering with exercise, a healthy diet, and adequate sleep, says Karina Davidson, Ph.D., co-director of the Center for Behavioral Cardiovascular Health at Columbia University Medical Center in New York.

Anger, anxiety, and depression are the main ways women channel stress, and each emotion has a profound effect on the heart, says Redford Williams, M.D., director of behavioral research at Duke University and author of In Control (Rodale, 2007). Our guide helps you cope with these difficult feelings and buffer your heart.
1. Lift Depression

Depression and heart disease are linked in two vital ways. The first is reactive depression, meaning many people suffer from depression because they've had a heart attack, says Oz. The second possibility is that depression may cause heart disease, a theory now gaining popularity among mental health experts. Studies show depression revs up stress hormones, which causes platelets in the blood to become sticky. Over time, platelet-packed blood damages blood vessels and causes artery walls to harden and thicken. "Blood with too many clumpy platelets is like the difference between ketchup and red wine," says Stephen Sinatra, M.D., cardiologist, assistant professor of medicine at the University of Connecticut, and author of Heart Sense for Women (Plume, 2001).

* Be aware. If symptoms of depression, such as insomnia, fatigue, and feelings of hopelessness, linger for more than two weeks, talk to your doctor. If necessary, seek support from a professional psychologist or therapist (see the American Psychological Association website at or talk to your doctor about antidepressants.
* Move your body. As you work through depression, maintain an exercise schedule. Experts say exercising for 30 minutes per day, five days a week infuses the brain with feel-good chemicals.
* Try supplements. Take 50 mg or 100 mg per day of 5-HTP (5-Hydroxytryptophan), a naturally occurring amino acid and precursor to the neurotransmitter serotonin. A capsule a day can boost your body's serotonin levels and help lift depression, says Judith Orloff, M.D., author of Emotional Freedom (Harmony Books, 2009), who suggests 5-HTP by Jarrow Formulas (jarrow .com). The supplement is considered safe, but rare side effects include nausea, headache, diarrhea, and low libido. Speak to your doctor before taking any supplements.
* 2. Assess Your Anger

"Men and women feel the same amounts of anger but women are taught that it's not socially acceptable to express it by yelling or throwing things," says Davidson. "So, instead they channel it through sarcasm, gossip, or passive-aggressive behavior — what researchers define as hostility." No matter how you express your anger you're hurting your heart. "It puts an incredible strain on the blood vessels," says Sinatra. Instead of vowing never to get angry, learn to take the ire out of it.

• Take stock. As your blood boils, ask yourself the following questions to determine if your anger is justified, says Redford Williams:

1. Is this something that's important to me?
2. Is my response appropriate to the situation?
3. Is there anything I can do about it?
4. Is taking action worth it in this situation?

If you answer "no" to any one of these questions, you need to talk yourself down, says Williams. Take a few deep breaths or distract yourself from the situation with meditation or quiet music. If you answer "yes" to all four, do something to change the situation, he says. If you're angry with your partner, for example, explain in neutral terms what it was that made you mad, explain how it affected you, and ask him or her to make a change. Be assertive, not angry.

* Speak your mind. Express your thoughts and frustrations, especially in your closest relationships. A 2007 study that looked at how couples resolved arguments found that women who held in their emotions or opinions when they disagreed with their partners had four times the risk of dying of heart disease than those who spoke up.
* Learn new habits. If ingrained behavioral patterns affect your ability to express or cope with your anger, see a cognitive behavioral therapist who can help you break them. You can find one through the National Association of Cognitive-Behavioral Therapists (
* 3. Calm Your Anxiety

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Worry stems from a part of the brain called the amygdala. "It's like the brain's fire alarm, always raising the alert because it thinks you're in danger," says Oz. That was useful for our ancestors who needed to jump into action to survive everything from rock slides to predators, but, in today's world, it's often overkill. Worse, the amygdala in women's brains is more prone to blast away. "We are all hardwired to worry," says Oz. "But these impulses are amplified for women during childbearing years, in part because if you were hyper-vigilant with offspring they were more likely to survive." When anxiety runs rampant, blood pressure climbs, heart rate skyrockets, and blood vessels dilate.

* Slow down. Calming, meditative forms of exercise, such as yoga or walking, can ameliorate anxiety.
* Cut out junk. Cut back on foods high in sugar and/or fat, which give you energy surges that exacerbate heart palpitations, make it difficult to calm down if you're already feeling agitated, and may even trigger an anxiety episode.
* Avoid stress at work. If your job causes you constant anxiety, consider ways to make it better or try to find a different job. People with high levels of work stress are 50 percent more likely than others to suffer from heart disease, according to a 2006 meta-analysis, published in the Scandinavian Journal of Work and Environmental Health. (The authors defined work stress as feeling powerless to change things coupled with high demands, low salaries, or organizational injustice.)
* Ask for help. Delegate tasks that trigger your anxiety, says Nieca Goldberg, M.D., director of the NYU Langone Medical Center's Women's Health Program and author of The Women's Healthy Heart Program (Ballantine, 2006). "Don't try to be superwoman," she says. If, for example, you find it difficult to keep the house tidy, ask your spouse or kids to help out or let the housework slide for a day or two.

Are you anxious? Too much anxiety can lead to high blood pressure. Signs of distress include a feeling of tightness in the chest and excessive sweating, says Judith Orloff, M.D., author of Emotional Freedom (Harmony Books, 2009). Try yoga or milking to calm down. Are you angry? Feelings of rage put extra strain on the heart. When you notice anger building (you sense a rush of blood to your hands and face, your throat clenches up, your stomach is in knots), try to relax and distract yourself with a few deep breaths, meditation, or quiet music. HEART DISEASE BASICS

Heart disease will take the lives of half a million women in the United States this year — nearly twice the toll of all cancers combined, according to the American Heart Association.

GET TESTED. One in three women already has heart disease, the nation's leading killer. But 64 percent of women who die suddenly from the disease have no prior symptoms.

KNOW YOUR RISKS. The more risk factors you have — being older, overweight, African American, or having a family history of heart disease — the greater your odds of getting the disease.

FOLLOW THE RULES. Cut saturated fat from your diet, quit smoking, and stay physically active. Get complete diet and exercise guidelines, and more on the symptoms of heart disease, from the American Heart Association (
Are you depressed? Being depressed can cause a hardening of your heart's arteries. If you're experiencing low moods, sluggish thinking, lethargy, or muffled senses, seek support from a psychologist or therapist, says Orloff. STAY CONNECTED

Social isolation and loneliness aggravate high blood pressure and dampen immunity, both of which negatively affect your heart. "I see a lot of loneliness, especially in big cities, where people have many acquaintances but few friends," says Newsha Ghodsi, M.D., a cardiologist in Manhattan and professor of cardiology at Mount Sinai Medical Center. She suggests the following measures:

JOIN A GROUP. Sign up for a cooking class or a book club, or volunteer at the local animal shelter.

GET A PET. If you don't have a pet, consider adopting one. In one study of heart attack survivors, dog owners were 8.6 times more likely to be alive a year later than people without dogs.

REACH OUT. Phone a friend you still feel close to but maybe haven't spoken to for a year or more. Put aside apologies or feelings of guilt and simply try to reconnect.

SHARE YOUR STORIES: Read about one woman's struggle with stress and heart disease and tell us your own story at


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