The heart of the matter

The happier and less stressed you are the more likely you are to avoid heart disease

The happier and less stressed you are the more likely you are to avoid heart disease. It's all about a good physical, emotional and intellectual balance, writes Anne Dempsey

The heart is a muscular pump placed slightly to the left in the middle of the chest, the size and shape of two clenched fits. It weighs between eight and 10 ounces and pumps blood, oxygen and nutrients around your body.

Medically it can be ailing, treated, mended, even replaced. Romantically it is associated with love, tenderness, emotion and passion and is reputedly capable of being touched, warmed, broken and mended.

The best way to love your heart and the heart of those you love is to look after it. It's now increasingly accepted that the exchange of flowers, vows, cards and caresses next Monday, St Valentine's Day, is truly good for your heart.

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These days as well as extolling the value of vegetables and the wonder of walking, the Irish Heart Foundation (IHF) is among a number of health-promoting bodies now recognising the link between emotional and heart health.

"Our aim is to help people move towards a state of optimal health now defined as a balance of physical, emotional, social, spiritual and intellectual health," says Dr Vincent Maher, IHF's medical director.

"The facts around psychological factors and cardiovascular disease indicate that people who feel loved, have friendship, companionship, are more likely to choose practices that enhance health. Resources such as close personal relationships that diminish negative emotions enhance health in part through their positive impact on immune regulation. The presence of social support and social networks may be as important as eliminating physical risk factors [such as smoking, inactivity, poor nutrition], in improving health and preventing premature deaths," he says.

Five key variables - acute stress, hostility, depression, lack of social support and poor socio-economic status - have been identified as possible psychosocial risk factors.

"Conversely, people who do not feel loved are three times more likely to die from heart attack and other diseases. Those who do not have a warm integrated community of contacts are two to four times more likely to die from heart disease, stroke, cancer, respiratory or gastrointestinal disease.

Negative emotions can intensify a variety of health threats including cardiovascular disease," says Maher.

A growing body of research shows that among heart disease patients, mental stress is as dangerous to the heart as physical stress.

"We identify stress as a mismatch between a situation in which someone is placed, and their ability to cope with it," says Maureen Mulvihill, Irish Heart Foundation's health promotion manager.

Stress releases cholesterol into the blood stream and raises blood pressure causing the heart to work harder.

Also high levels of stress increase secretion of noradrenaline, the "aggression hormone" whose most potent action is constriction of blood vessels which can deprive the heart of oxygen.

Ongoing stress also increases the prevalence of other risk factors for heart disease such as smoking and lack of exercise.

However, people may be more motivated to change their behaviour, lessen the stress and love their heart if they understand exactly why they should.

Healthy messages which suggest change without explaining the reasons may fall on deaf ears. So what exactly is the connection between heart disease and smoking/fatty foods/alcohol? And why does taking exercise lower your risk of developing it?

"First, diet. If we eat more fat than we need, the excess attaches to the walls of the arteries, slowly cementing and hardening them. Also, the arterial walls thicken, narrowing the channels making it difficult for blood to pass through to the heart," says Maher.

The emphasis these days is on eating more fruit, vegetables, breads, cereals, rice and pasta as part of a healthy diet. "Fish for Your Heart", a new initiative by IHF/BIM, explains how oily fish with omega-3 fats reduce the risk of heart disease and offers a range of recipes available from fish counters or from www.bim.ie.

People who exercise are more likely to have a generally healthy lifestyle, for example, they may not be smokers. Exercise burns off calories and helps to maintain a healthy weight.

Thirdly, a fit person unfortunate enough to have a heart attack will be in a better position to fight it and will probably return to a better quality of health after it.

Why is smoking bad for the heart? "There are about 1,500 reasons when you consider the ingredients in tobacco. But smoking is harmful in two major ways. First, nicotine constricts the arteries, and carbon monoxide makes the blood less effective in carrying oxygen. Second, smoking promotes clotting through its effect on the blood."

Excessive alcohol may damage the heart indirectly through liver damage and increased risk of high blood pressure.

The news some years ago that one to two glasses of red wine per day has a protective function against heart disease was good news for social drinkers. So when toasting each other tenderly next Monday night, you can do it with a virtuous glow.