In June an article entitled “How stress can clog your arteries” was published by the American Association for the Advancement of Science. A group of scientists have investigated why people who are suffering from chronic stress are more likely to have increased atherosclerosis (a build-up of plaque in their artery walls that can lead to heart attack, amongst other things). Blood samples from stressed-out medical students revealed they had increased levels of immune cells in their blood. Subsequent laboratory testing successfully duplicated these findings.1 The poor stressed-out mice had increased levels of neutrophils and monocytes as well as increased incidence of risky atherosclerotic plaques at danger of rupturing and causing life threatening blockages. The findings were conclusive; stressed-out mice are at greater risk of heart disease.
This is incredible news! They found a definite link between stress and cardiovascular disease. Alternative medicine has long emphasised the importance of reducing stress but conventional medicine has not explored the possibility of a direct connection in much detail before this study. It is well recognised that stress is contributing to the majority of illnesses such as high blood pressure, Irritable Bowel Syndrome (IBS), and susceptibility to seasonal infections. Despite this, little is taught of how to reduce stress and it is rare to find a GP who would suggest mediTation to a patient before, or even in conjunction with, mediCation. That is why the results of this study are exciting. A definite link means that this very important aspect of wellness may start to be recognised as a major player in overall health in the conventional medical model.
But in true conventional medicine style, the article then mentions some possible outcomes of this research including a pharmaceutical drug to block the excess production of the offending immune cells, and then this telling quote from Alan Tall, a physician and atherosclerosis researcher at Columbia University:
“Rather than asking four questions about stress levels, we could use their [patient’s] white blood cell counts to monitor psychosocial stress,”
A blood test for stress!? Is this a step forward or a step backwards? Increased diagnostic powers can have definite advantages, and sometimes patients might not know when they are stressed, particularly if it is chronic stress but Tall specifically refers to saving time. Why talk when you can test instead? This is concerning in an age of disconnect, where people are feeling more isolated and helpless. Over the past few decades the world of medicine and pharmaceuticals has become increasingly advanced and often beyond the comprehension of most people without specialist knowledge. The result is that patients lose their agency and ability to make their own informed decisions. Complicated, multifactorial conditions such as hypertension (high blood pressure), Parkinson’s disease and cancer can require this specialist medical knowledge, but reducing stress definitely does not. A blood test for stress would ‘medicalise’ it, taking it out of patients’ hands where it belongs, and putting the responsibility on the doctors and the health care system. Research should focus on how to best communicate the importance of stress reduction to patients, and diet too while they are at it.
There is a long way to go for our health system before GP appointments can be long enough for good conversation. Regardless, the results of this study could provide a fantastic stepping-stone in the path towards involving the patient back in their own health. It would be fantastic to see these results encouraging doctors to talk to their patients again and to build relationships with them. To find out about their lives, whether they are happy or unhappy, and what stresses are impacting on them. Engage patients, educate them, and encourage them to be partners in their own healing.
Reducing chronic stress is one area of health care where the patient has the ability to prescribe and initiate their own treatment. The link between stress and atherosclerosis paves the way for GPs and cardiologists to take a look at the sources of chronic stress in their patients’ lives and start referring them to psychologists, counsellors, massage therapists, yoga and meditation classes and suggesting long baths, cups of tea, and more convenient working hours. Give the power back to the patients!
- Here is the full reference for the paper. Unfortunately I cannot access it as it is behind a pay wall.
Heidt T, Sager HB, Courties G, Dutta P, Iwamoto Y, Zaltsman A, von Zur Muhlen C, Bode C, Fricchione GL, Denninger J, Lin CP, Vinegoni C, Libby P, Swirski FK, Weissleder R, Nahrendorf M
Chronic variable stress activates hematopoietic stem cells
Nature Med. 2014;20(7):754-758 – PMID: 24952646 – PMCID: PMC4087061