By Dr. Liji Thomas, MD Jan 14 2020
A new study published in January 2020 in the European Journal of Preventive Cardiology shows that burnout could really cause your heart to fail as a result of an abnormal heart rhythm called atrial fibrillation (AF). This is the most common cardiac arrhythmia, affecting about 17 million people in Europe alone, and double that number worldwide. It can cause distressing chest symptoms including palpitations, shortness of breath and tiredness, or silently kill the patient. It is the most common cause of stroke in all Western nations. Image Credit: MAD.vertise / Shutterstock
Though many risk factors for AF have been identified, these account for only about half of the cases. The presence of mental distress has been suggested to be one factor that could explain some of these cases.
Psychological distress could activate autonomic nervous system pathways such as the sympathetic nerves that trigger body-wide arousal and hypervigilance, stress and higher stress hormone levels. It can also make the hypothalamo-pituitary-adrenal axis more sluggish, while also affecting the renin-angiotensin-aldosterone system, which affects both the blood pressure and heartbeat. Finally, psychological distress could directly influence the activity of the pacemakers in the heart, called the sinoatrial and atrioventricular nodes, causing an irregular heartbeat. What is already known?
Earlier studies on psychological health and new AF have not always been clear in their findings. The first analyses were carried out on mostly white people and showed no link between depression or chronic stress with AF. They did demonstrate that anger, hostility and tension were associated with AF in men alone.
A later study from Denmark shows that antidepressant usage is highly associated with AF. The Multi-Ethnic Study of Atherosclerosis shows a link between new AF and depression, but not with chronic stress, anger or anxiety. The current study was meant to evaluate the role of specific psychosocial measures that could show the presence of underlying psychological distress, in the causation of new AF, using data from the Atherosclerosis Risk in Communities (ARIC) study, including both whites and blacks. The scientists tested for the role of both vital exhaustion and negative emotions including anxiety, anger and depression.
Vital exhaustion is a condition of severe tiredness, with a feeling of being unmotivated and unanxious to go on, with increased irritability. A loss of vigor and excessive fatigue are the primary features of exhaustion, but not depression. According to researcher Parveen K. Garg, “Burnout can be any sort of stressor -- it doesn't necessarily have to be work. It can be personal stress, home or family tension. It's anyone who is chronically stressed and who suffers from chronic exhaustion.”
Vital exhaustion is a state in which the general inflammatory response is heightened, as well as a reduction in the tonic activity of the HPA which regulates the stress response of the body. Higher inflammation and stress responses are a killer combination. The study
The researchers looked at over 11,400 people who were part of the Atherosclerosis Risk in Community Studies in 1987-89. The mean age was about 57 years. All had no evidence of AF at the beginning of the current study in 1990 to 1992. The participants were first evaluated for vital exhaustion at the start of the study in 1990-92 and assigned a score in the top quartile on the Vital Exhaustion Questionnaire (VEQ). Related Stories
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