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Stress, anger can worsen heart failure

Scientists at the Yale University in the United States (US), said that stress and anger may have clinical implications for patients with heart failure. According to a new report published in the ‘Journal of Cardiac Failure,’ people who experience chronically elevated levels of stress and anger have a more burdensome disease course with diminished quality of life and increased risk for adverse events.

Heart failure is a chronic condition in which the heart doesn’t pump blood as well as it should and it can occur if the heart cannot pump (systolic) or fill (diastolic) adequately. Heart failure can lead to a reduced ejection fraction, in which the heart muscle pumps out a lower amount of blood than is typical with each contraction. The researchers at Yale University analysed patients who had heart failure with reduced ejection fraction and evaluated the effects of stress and anger on diastolic function. Diastolic function describes the ability of the heart to relax and refill between muscle contractions.

The ‘Science Daily’ reported that for one week, participants completed daily questionnaires about their experiences of stress, anger, and negative emotions during the previous 24 hours. Subsequently, they described a recent stressful experience. Echocardiograms were performed to assess diastolic function at rest and during the stress task. According to the ‘Science Daily’ report, patients who reported experiencing anger in the week prior to the laboratory mental stress protocol exhibited worse baseline resting diastolic pressure.

Furthermore, most patients demonstrated stressprovoked changes in diastolic function, including decreased early relaxation and increased diastolic pressure. Lead study author, Kristie Harris, a postdoctoral associate in cardiovascular medicine at Yale University, said: “Mental stress is common in patients with heart failure due in part to the complexities of disease self-management, progressively worsening functional limitations, and frequent symptom exacerbations and hospitalisations.”

Speaking further, Harris said: “We have evidence that patientswhoexperiencechronically elevated levels of stress experience a more burdensome diseasecoursewithdiminished quality of life and increased risk for adverse events.” However, he stressed that clarifying the relevant behavioural and physiological pathways were especially important in the era of COVID-19 when the typical stressors of heart failure may be further compounded by pandemicrelated stressors.

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