Ask the Doctors

Dear Doctor: I've been hearing on the news that researchers have discovered that when stress causes a heart attack, it all begins in the brain. How does this work? And is it even possible to control the way our brain responds?

Dear Reader: Before we dive into the details of the intriguing revelations regarding stress and heart health, we'd like to share some soothing news. The same mind-body connection that researchers believe plays a role in heart attack may also offer a measure of protection through techniques like meditation, yoga and mindful relaxation.

Let's start with the known risk factors for cardiovascular disease, which have been front-page news for decades. Obesity, high cholesterol, hypertension, diabetes and smoking -- we doubt any of our readers are surprised by that lineup. And while mental and emotional stress have long been suspected to contribute to heart disease, the exact mechanism has remained a mystery.

Now researchers from Harvard Medical School have identified the part of the brain that plays a significant role in cardiovascular disease. Known as the amygdala, it's a small, almond-shaped area associated with processing emotion. The amygdala receives and interprets input from throughout the brain. When incoming signals point to danger, the amygdala reacts instantly, bypassing conscious choice. It sets the sympathetic nervous system, which regulates the fight-or-flight reflex, into action.

Using imaging techniques to measure brain activity, the researchers could link increased activity in the amygdala to increased production of white blood cells by the bone marrow. This led to inflammation in the arteries, which is a risk factor for heart attack and stroke.

The good news is that by using techniques to reduce the stress response, we not only feel more calm and serene, but the benefits can also extend to cardiovascular health. So be good to your amygdala (and to your heart) and consider some options.

Many workplaces, community centers, university extension programs and senior citizen centers now offer stress-reduction programs. At the very least, they will bring you together with like-minded individuals. Social isolation is associated with increased stress, so simply becoming part of a community with a common goal is a step forward.

Yoga has long been shown to reduce stress and promote physical, emotional and mental well-being. In fact, studies show that individuals who practice yoga regularly have lower levels of certain stress chemicals in their blood than those who don't do yoga. And although many forms of yoga have sprung up over the years -- some of them quite fast-paced and with a mindset that is almost competitive -- we recommend the gentle and measured approach of basic hatha yoga.

Meditation is also quite effective at reducing stress. Again, studies have shown that people who meditate regularly for just as little as 20 minutes per day reduced their blood pressure and reported feeling less stressed than did their non-meditating counterparts.

Tai chi, Pilates and deep breathing are also good for stress reduction. And don't forget the healing power of the natural world. A contemplative walk in the woods or a park will help you leave your worries behind.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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