Scientists
have shown that anger, anxiety, and depression not only affect the functioning
of the heart, but also increase the risk for heart disease.
Stroke
and heart attacks are the end products of progressive damage to blood vessels
supplying the heart and brain, a process called atherosclerosis.
Atherosclerosis progresses when there are high levels of chemicals in the body
called pro-inflammatory cytokines.
It
is thought that persisting stress increases the risk for atherosclerosis and
cardiovascular disease by evoking negative emotions that, in turn, raise the
levels of pro-inflammatory chemicals in the body.
Researchers
have now investigated the underlying neural circuitry of this process, and
report their findings in the current issue of Biological Psychiatry.
“Drawing
upon the observation that many of the same brain areas involved in emotion are
also involved in sensing and regulating levels of inflammation in the body, we
hypothesized that brain activity linked to negative emotions – specifically
efforts to regulate negative emotions – would relate to physical signs of risk
for heart disease,” explained Dr. Peter Gianaros, Associate Professor at the
University of Pittsburgh and first author on the study.
To
conduct the study, Gianaros and his colleagues recruited 157 healthy adult
volunteers who were asked to regulate their emotional reactions to unpleasant
pictures while their brain activity was measured with functional imaging. The
researchers also scanned their arteries for signs of atherosclerosis to assess
heart disease risk and measured levels of inflammation in the bloodstream, a
major physiological risk factor for atherosclerosis and premature death by
heart disease.
They
found that individuals who show greater brain activation when regulating their
negative emotions also exhibit elevated blood levels of interleukin-6, one of
the body’s pro-inflammatory cytokines, and increased thickness of the carotid
artery wall, a marker of atherosclerosis.
The
inflammation levels accounted for the link between signs of atherosclerosis and
brain activity patterns seen during emotion regulation. Importantly, the
findings were significant even after controlling for a number of different
factors, like age, gender, smoking, and other conventional heart disease risk
factors.
“These
new findings agree with the popular belief that emotions are connected to heart
health,” said Gianaros. “We think that the mechanistic basis for this
connection may lie in the functioning of brain regions important for regulating
both emotion and inflammation.”
These
findings may have implications for brain-based prevention and intervention
efforts to improve heart health and protect against heart disease.”
“It
is remarkable to see the links develop between negative emotional states, brain
circuits, inflammation, and markers of poor physical health,” said Dr. John
Krystal, Editor of Biological Psychiatry. “As we identify the key mechanisms
linking brain and body, we may be able to also break the cycle through which
stress and depression impair physical health.”
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