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Healthy Heart

Know Your Risks

Are Your Relationships Putting Your Heart at Risk?

Caregiver stress, divorce anxiety, a family feud … relationship strains can affect your cardiovascular health. A Johns Hopkins expert explains the connection and offers strategies to reduce heart risks.

What the Experts Do
Run to a Stress Outlet

People often make the mistake of choosing a stress outlet like having a drink or devouring a bag of chips, which feels good in the moment but is ultimately harmful. “It’s important to find your ‘happy place’ for managing stress,” says Johns Hopkins cardiologist Erin Michos, M.D. She sheds her work, life and relationship stresses by running. “I’m always so tired when I start, but by the end I’m full of energy and relaxed,” says Michos, who hits the pavement at 5 a.m.

We look to relationships to warm our hearts, but did you know they could also lead to heart damage?

Everyone’s life has some stress, including people-related sources. Maybe you argued with your partner, for example, or feel anxious about planning a special dinner for your in-laws. But when relationship strains are intense or prolonged, the heart may suffer in physiological ways.

“Many studies suggest that emotional stress is hard on your health—raising blood pressure and heart rate, for example,” says Johns Hopkins cardiologist Erin Michos, M.D. When the stress becomes chronic, so do these physical effects. Over time, that can lead to heart damage.

Recognize Stress Sources and Heart Risks

Although everyone experiences stress in different ways, certain relationship situations are more likely to set the stage for chronic stress. Examples include being in a caregiver role, really struggling to balance work and family, living in an unhappy marriage, or going through a divorce.

“Some recent research shows that the effects of emotional stress may be more pronounced in women,” says Michos. For example, a 2015 study of heart attack survivors, reported in the journal Circulation, found that women had significantly higher levels of psychological stress than men, and this may explain why they also had poorer recoveries.

The majority of the women’s stresses were related to family conflicts and the death or illness of relatives. (Men were more stressed about business and finances.)

“Women perceive greater psychological stress than men,” Michos says.

Another 2015 study showed that divorce is a significant risk factor for heart attack, and for women, especially, the risk rises with multiple divorces, even if there’s a later remarriage.

Heart-Smart Ways to Approach Relationship Stress

You can’t rid your life of all relationships—and you wouldn’t want to because healthy relationships can be stress buffers. But these steps can help, Michos says:

  • Share life stresses with your doctor. If you’re a caregiver or are in the midst of a divorce, this information can provide context for your symptoms that can lead to more personalized care. Your doctor may be able to point you to support resources or want to monitor aspects of your health more closely, for example.
     
  • Check your coping strategies. “Many people respond to stress by smoking, drinking or overeating, but that’s counterproductive,” Michos says.
     
  • Find stress outlets that make you feel better right away and in the long term. Helpful strategies include yoga, meditation, exercise, and a support system of friends and family members you can talk to and enjoy.
     
  • Make taking care of yourself a top priority. Women, especially, tend to put everyone else first. Don’t neglect checkups.
     
  • Pay attention to new symptoms. Don’t write off palpitations or chest pain as “just stress.” Realize that women often have atypical heart symptoms, such as pain in the jaw or arm, or nausea.

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