Chris D. Meletis, ND
This is the third and final part of a series discussing the various ways stress affects bodily systems. In this installment I will address the ways in which stress damages the heart, causes an increase in blood pressure and reduces longevity.
It is well established that long-term stress can erode optimal health and accelerate the biological clock. In a study of centenarians, researchers found that a common trait among the subjects was their tendency to react with a low anxiety intensity to stressful conditions and that they reacted positively to stress.1
Scientists have tracked the consequences of stress on cellular aging by determining the effect of stress on telomere length. Telomeres are the specialized genetic segments that cap and protect the ends of chromosomes. Telomeres help determine cell longevity and shortening of telomeres is linked to cancer and cardiovascular disease. Balanced levels of telomerase, an enzyme that prevents telomere shortening, are advantageous in protecting cells against aging.
Research shows that psychological stress—both perceived stress and chronic stress—is significantly associated with higher oxidative stress, lower telomerase activity and shorter telomere length in peripheral blood mononuclear cells (PBMC) from healthy premenopausal women. Women with the highest levels of perceived stress have telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low-stress women.2
Furthermore, scientists have shown that caregivers of Alzheimer’s disease patients have significantly shorter telomere lengths in PBMCs than controls. These same caregivers had basal telomerase activity in PBMCs and T cells that was significantly higher than in controls, indicating cells were unsuccessfully attempting to compensate for the excessive loss of telomeres.3
Likewise, children who experienced adversity were later shown as adults to have significantly shorter telomeres compared to those who did not report a childhood history of maltreatment.4
To further cement the relationship between long-term psychological stress and telomere shortening, researchers exposed human T lymphocytes to the stress hormone cortisol and noted a significant reduction in telomerase activity.5
Impaired telomerase activity also has been associated with the major risk factors for cardiovascular disease: smoking, poor lipid profile, high systolic blood pressure, high fasting glucose and greater abdominal adiposity. Telomere length itself was related to elevated stress hormones (catecholamines and cortisol).6
Cardiac Health and Stress
Numerous studies have demonstrated a strong link between chronic stress and heart disease. In 388 Chinese subjects (292 coronary heart disease cases and 96 controls) aged 30 to 70 years who received coronary angiography for suspected or known ischemic heart disease, researchers examined the association between job stress and coronary heart disease (CHD). The job stress before CHD onset was measured by the effort-reward imbalance (ERI) model, where the researchers measured the amount of effort invested compared to the amount of reward received for those efforts. The results indicated that compared with the baseline, high ERI, high extrinsic effort or high over commitment increased the risk of CHD after adjustment for the traditional CHD risk factors, such as age, gender, primary hypertension, hyperlipidemia, smoking and CHD family history. The combination of high ERI and high over commitment led to the highest risk of CHD. However, high reward reduced the risk of CHD. The researchers concluded that job stress evaluated by the ERI model significantly increased CHD risk, and that it may be an important risk factor independent of the traditional risk factors.7
Scientists also have measured the physical effects of stress in subjects shown a 3-minute frightening video. The fear-induced stress resulted in vasoconstriction (blood vessel narrowing) in the forearm and finger.8
After the World Trade Center attack in 2001, the same negative effect of stress on the heart was noted. In one study, researchers in Florida observed 132 patients with implantable cardioverter-defibrillators (ICD) during routine ICD follow-up around the time of the WTC attack. In the 30 days following the WTC attack, a total of 14 patients (11 percent) had ventricular tachyarrhythmias, compared with 5 (3.8 percent) in the preceding 30 days, numbers that represent a 2.8-fold risk increase.9
The study authors concluded, “The frequency of ventricular arrhythmias requiring ICD treatment increased by 68 percent among patients in Florida around the WTC attack. These findings suggest that stress-related arrhythmogenesis due to the WTC tragedy was not restricted to the geographic location of the attack. A major national tragedy may cause widespread increased risk of potentially life-threatening ventricular arrhythmias.”
Stress and Blood Pressure
Excessive stress has been linked to hypertension in a number of studies. An analysis of the medical literature included 6 studies involving a total of 34,556 subjects. After assessing the studies, the scientists found that individuals who had stronger responses to stressor tasks were 21 percent more likely to develop blood pressure increase when compared to those with less strong responses.10
One of the ways in which stress elevates blood pressure is through the renin-angiotensin-aldosterone system, a cascade that regulates and maintains blood pressure.
The angiotensin-converting enzyme (ACE) gene is associated with the vulnerability for stress-related disorders and with altered stress hormone regulation.11-12 Blood pressure drugs known as ACE inhibitors work by blocking this enzyme.
Even acute mental stress can have prolonged negative effects on factors that help regulate blood pressure. One study investigated the effects of a mental arithmetic test on 19 healthy subjects. Aortic stiffness was then measured in the subjects. The results indicated that mental stress induced a sustained increase in aortic stiffness.13
A nutritional supplement regimen can be designed around protecting the heart from psychological stress and increasing overall longevity. This regimen includes supplements to reduce anxiety and stress and to support heart health and healthy blood pressure.
A combination of gamma-aminobutyric acid (GABA), L-theanine, ashwaganda, valerian and passion flower (all found in Allay™) can be extremely helpful in inducing a state of calm relaxation.
GABA is the major inhibitory neurotransmitter in the brain (i.e., it regulates brain excitability and nerve transmission). In human studies, GABA supplementation has been shown to induce relaxation and reduce anxiety.14-15
L-Theanine, an amino acid found in green tea, reduces stress-induced physiological responses (changes in heart rate, sympathetic nervous system activation),16 and decreases the brain’s production of excitatory neurotransmitters while increasing inhibitory neurotransmitters such as GABA.17
Withania somnifera, also known as Ashwaganda, is an adaptogen reported to have mood stabilizing, anxiolytic (anxiety-reducing) and antidepressant actions.18-19 It also has been shown to attenuate physiological stress responses and positively influence the endocrine and central nervous systems.20-21
Valerian (Valeriana officinalis) exerts a regulatory effect on the autonomic nervous system and has been demonstrated to bind to benzodiazepine and GABA receptors,22-23 providing a tranquilizing effect, improving sleep quality and decreasing the time it takes to fall asleep.
Passion flower has anxiety-reducing effects and has an important role in reducing tenseness, restlessness and irritability with difficulty in falling asleep.24
Optimizing Heart Health
A combination of CoQ10, taurine, L-arginine, L-carnitine, hawthorn and salvia (as found in CardioCare) can support the health of the heart during stressful times.
Coenzyme Q10 is essential to cellular energy processes and thus assumes importance in cells with high-energy requirements such as the cardiac cells, which are extremely sensitive to CoQ10 deficiency produced by cardiac diseases. CoQ10 is a vasodilator (widens the blood vessels). It inhibits LDL oxidation and thus the progression of atherosclerosis and decreases blood viscosity, which is helpful in patients with heart failure and coronary artery disease. Researchers have noted significant improvement in exercise tolerance in patients with heart failure, hypertension, ischemic heart disease and other cardiac illnesses who were given adjunctive CoQ10 in doses from 60 to 200 mg daily.25
Other nutrients important for cardiac health include taurine and L-arginine. Deficiencies of these nutrients are linked to heart arrhythmias. Case histories of people with very frequent arrhythmias have shown that 10-20 grams of taurine per day reduced premature atrial contractions (PACs) by 50 percent and prevented all premature ventricular contractions (PVCs), but did not prevent pauses. Adding 4-6 grams of L-arginine immediately terminated essentially all remaining pauses and PACs, maintaining normal cardiac rhythm with continued treatment.26
L-arginine also has been found to enhance endurance exercise tolerance in heart failure patients.27
Carnitine is another nutrient important to proper cardiac functioning and has been shown to reduce LDL oxidation, the process by which free radicals damage lipids in the body and play a role in LDL’s heart-damaging effects.28
Hawthorn has proven itself to be equally important to healthy heart function. A review of the medical literature found that hawthorn extract may improve symptoms in patients with mild to moderate heart failure, significantly enhancing exercise tolerance and reducing shortness of breath and fatigue. Hawthorn extract also increased the maximum workload in a small number of studies and patients.29
Salvia miltiorrhiza is another botanical important to cardiovascular health. Salvia protects cardiac cells known as myocytes from damage and has protected animal hearts from injury after oxygen deprivation.30-31
Maintaining Healthy Blood Pressure
Natural products have many different mechanisms to modulate blood pressure. Cordyceps and shark cartilage, as found in PRESSURE-fX™, address both the renin-angiotensin system as well as parathyroid hypertensive factor (PHF), both of which are implicated in high blood pressure. Animal models show that shark cartilage administration decreased blood pressure and modulated intracellular calcium regulation.32 Studies indicate that Cordyceps also lowers blood pressure in animal models, relaxes blood vessels, and elicits a dose-dependent relaxation of extra-cellular calcium-dependent contractions.33 A clinical trial with hypertensive patients showed that adding PRESSURE-fX was more effective at lowering blood pressure than diet, lifestyle modifications and mineral supplementation alone. In fact, 88 percent of subjects had significantly reduced blood pressure, and 75 percent of subjects were able to maintain normal blood pressure without medication.34
In patients whose blood pressure issues are being caused by nitric oxide deficiency, increased ACE activity and arterial calcification, a combination of grape seed extract, a special form of blueberry extract and vitamin K2 (as in DilaVasic BP™) can often be useful. Grape seed extract has been shown to increase platelet-derived nitric oxide production, which induces relaxation of blood vessels.35-36 One clinical trial showed that 300 mg per day of grape seed extract supplemented for 8 weeks decreased systolic blood pressure by an average of 8.3 mmHg and diastolic blood pressure by 5.7 mmHg.37
Research also suggests that blueberry extract acts as a potent ACE inhibitor. In one study, a diet containing 3 percent blueberry extract or a control diet was fed to spontaneously hypertensive stroke-prone rats for 8 weeks. The blood pressure of the spontaneously hypertensive stroke-prone rats was 30 percent lower on the blueberry diet than on control diet at 6 weeks. In addition, the rats on the blueberry diet showed a 48 percent lower glucose/insulin ratio compared to rats on the control diet.38
Vitamin K2 (menaquinone) can also be an important part of a blood-pressure-maintenance formula. Vitamin K2 promotes arterial elasticity by inhibiting calcification of blood vessel walls.39-40
Stress has been shown to damage the cardiovascular system and decrease life span. Clearly, reducing stress levels with Allay, improving the health of the heart with CardioCare plus extra CoQ10, taurine and L-arginine and reducing blood pressure levels with either DilaVasic BP or PRESSURE-fX can help the body recover from lifetime challenges while at the same time restore optimal heart health.
1. Tafaro L, Tombolillo MT, Brükner N, Troisi G, Cicconetti P, Motta M, Cardillo E, Bennati E, Marigliano V. Stress in centenarians. Arch Gerontol Geriatr. 2009 May-Jun;48(3):353-5.
2. Epel ES, Blackburn EH, Lin J, Dhabhar FS, Adler NE, Morrow JD, Cawthon RM. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci U S A. 2004 Dec 7;101(49):17312-5.
3. Damjanovic AK, Yang Y, Glaser R, Kiecolt-Glaser JK, Nguyen H, Laskowski B, Zou Y, Beversdorf DQ, Weng NP. Accelerated telomere erosion is associated with a declining immune function of caregivers of Alzheimer’s disease patients. J Immunol. 2007 Sep 15;179(6):4249-54.
4. Tyrka AR, Price LH, Kao HT, Porton B, Marsella SA, Carpenter LL. Childhood Maltreatment and Telomere Shortening: Preliminary Support for an Effect of Early Stress on Cellular Aging. Biol Psychiatry. 2009 Oct 13. Published Online Ahead of Print.
5. Choi J, Fauce SR, Effros RB. Reduced telomerase activity in human T lymphocytes exposed to cortisol. Brain Behav Immun. 2008 May;22(4):600-5.
6. Epel ES, Lin J, Wilhelm FH, Wolkowitz OM, Cawthon R, Adler NE, Dolbier C, Mendes WB, Blackburn EH. Cell aging in relation to stress arousal and cardiovascular disease risk factors. Psychoneuroendocrinology. 2006 Apr;31(3):277-87.
7. Xu W, Zhao Y, Guo L, Guo Y, Gao W. Job stress and coronary heart disease: a case-control study using a Chinese population. J Occup Health. 2009;51(2):107-13.
8. Hayashi N, Someya N, Maruyama T, Hirooka Y, Endo MY, Fukuba Y. Vascular responses to fear-induced stress in humans. Physiol Behav. 2009 Oct 19;98(4):441-6.
9. Shedd OL, Sears SF Jr, Harvill JL, Arshad A, Conti JB, Steinberg JS, Curtis AB. The World Trade Center attack: increased frequency of defibrillator shocks for ventricular arrhythmias in patients living remotely from New York City. J Am Coll Cardiol. 2004 Sep 15;44(6):1265-7.
10. Gasperin D, Netuveli G, Dias-da-Costa JS, Pattussi MP. Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies. Cad Saude Publica. 2009 Apr;25(4):715-26.
11. Ge D, Zhu H, Huang Y, Treiber FA, Harshfield GA, Snieder H, Dong Y. Multilocus analyses of Renin-Angiotensin-aldosterone system gene variants on blood pressure at rest and during behavioral stress in young normotensive subjects. Hypertension. 2007 Jan;49(1):107-12.
12. Heck A, Lieb R, Ellgas A, Pfister H, Lucae S, Erhardt A, Himmerich H, Horstmann S, Kloiber S, Ripke S, Müller-Myhsok B, Bettecken T, Uhr M, Holsboer F, Ising M. Polymorphisms in the angiotensin-converting enzyme gene region predict coping styles in healthy adults and depressed patients. Am J Med Genet B Neuropsychiatr Genet. 2009 Jan 5;150B(1):104-14.
13. Vlachopoulos C, Kosmopoulou F, Alexopoulos N, Ioakeimidis N, Siasos G, Stefanadis C. Acute mental stress has a prolonged unfavorable effect on arterial stiffness and wave reflections. Psychosom Med. 2006 Mar-Apr;68(2):231-7.
14. No authors listed. Gamma-aminobutyric acid (GABA), Monograph. Altern Med Rev. 2007 Sep;12(3):274-9.
15. Abdou AM, Higashiguchi S, Horie K, Kim M, Hatta H, Yokogoshi H. Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans. Biofactors. 2006;26(3):201-8.
16. Kimura K, Ozeki M, Juneja LR, Ohira H. L-Theanine reduces psychological and physiological stress responses. Biol Psychol. 2007 Jan;74(1):39-45.
17. Yamada T, Terashima T, Okubo T, Juneja LR, Yokogoshi H. Effects of theanine, r-glutamylethylamide, on neurotransmitter release and its relationship with glutamic acid neurotransmission. Nutr Neurosci. 2005 Aug;8(4):219-26.
18. Bhattacharya SK, Bhattacharya A, Sairam K, Ghosal S. Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study. Phytomedicine. 2000 Dec;7(6):463-9.
19. Gupta GL, Rana AC. Protective effect of Withania somnifera dunal root extract against protracted social isolation induced behavior in rats. Indian J Physiol Pharmacol. 2007 Oct-Dec;51(4):345-53.
20. Bhattacharya SK, Bhattacharya A, Sairam K, Ghosal S. Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study. Phytomedicine. 2000 Dec;7(6):463-9.
21. Gupta GL, Rana AC. Protective effect of Withania somnifera dunal root extract against protracted social isolation induced behavior in rats. Indian J Physiol Pharmacol. 2007 Oct-Dec;51(4):345-53.
22. No authors listed. Valeriana officinalis, Monograph. Altern Med Rev. 2004 Dec;9(4):438-41.
23. Benke D, Barberis A, Kopp S, et al. GABA(A) receptors as in vivo substrate for the anxiolytic action of valerenic acid, a major constituent of valerian root extracts. Neuropharmacology. 2008 Jun 17. Published Online Ahead of Print.
24. Krenn L. Passion Flower (Passiflora incarnata L.)—a reliable herbal sedative. [Article in German]. Wien Med Wochenschr. 2002;152(15-16):404-6.
25. Kumar A, Kaur H, Devi P, Mohan V. Role of coenzyme Q10 (CoQ10) in cardiac disease, hypertension and Meniere-like syndrome. Pharmacol Ther. 2009 Jul 25. [Epub ahead of print]
26. Eby G, Halcomb WW. Elimination of cardiac arrhythmias using oral taurine with l-arginine with case histories: Hypothesis for nitric oxide stabilization of the sinus node. Med Hypotheses. 2006;67(5):1200-4.
27. Doutreleau S, Mettauer B, Piquard F, Rouyer O, Schaefer A, Lonsdorfer J, Geny B. Chronic L-arginine supplementation enhances endurance exercise tolerance in heart failure patients. Int J Sports Med. 2006 Jul;27(7):567-72.
28. Malaguarnera M, Vacante M, Avitabile T, Malaguarnera M, Cammalleri L, Motta M. L-Carnitine supplementation reduces oxidized LDL cholesterol in patients with diabetes. Am J Clin Nutr. 2009 Jan;89(1):71-6.
29. Pittler MH, Guo R, Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane Database of Systematic Reviews 2008, Issue 1.
30. Ling S, Luo R, Dai A, Guo Z, Guo R, Komesaroff PA. A pharmaceutical preparation of Salvia miltiorrhiza protects cardiac myocytes from tumor necrosis factor-induced apoptosis and reduces angiotensin II-stimulated collagen synthesis in fibroblasts. Phytomedicine. 2009 Jan;16(1):56-64.
31. Nie R, Xia R, Zhong X, Xia Z. Salvia miltiorrhiza treatment during early reperfusion reduced postischemic myocardial injury in the rat. Can J Physiol Pharmacol. 2007 Oct;85(10):1012-9.
32. Communication with Peter Pang, Ph.D., professor emeritus, University of Alberta, December 2001.
33. Pang PK, Shan JJ, Chiu KW. The Cardiovascular Effects of Cordyceps Sinensis in Normotensive Rats. Journal of Chinese Medicine. 1996; 7(2):153-167.
34. Malina O, Malina M, Kotsifas G, et al. Treatment of Mild to Moderate Arterial Hypertension with Pressure-FX®. Unpublished research. Instituto de Medicina Ortomolecular, Parana, Brazil.
35. Edirisinghe I, Burton-Freeman B, Tissa Kappagoda C. Mechanism of the endothelium-dependent relaxation evoked by a grape seed extract. Clin Sci (Lond). 2008 Feb;114(4):331-7.
36. Freedman JE, Parker C, Li L, et al. Select flavonoids and whole juice from purple grapes inhibit platelet function and enhance nitric oxide release. Circulation. 2001;103:2792-8.
37. Lu B, Robinson M, Kappagoda T. Effect of a Novel Grape Seed Extract on Blood Pressure in Subjects with Prehypertension. Presented at the FASEB Experimental Biology Conference, Washington, DC, April 30, 2007.
38. Sweeney M, Shaughnessy K, Gottschall-Pass K. Blueberry diets delay the onset of hypertension and reduce insulin resistance in spontaneously hypertensive stroke prone rats. FASEB J. 2007;21:847.
39. Schurgers LJ, Cranenburg EC, Vermeer C. Matrix Gla-protein: the calcification inhibitor in need of vitamin K. Thromb Haemost. 2008 Oct;100(4):593-603.
40. Beulens JW, Bots ML, Atsma F, et al. High dietary menaquinone intake is associated with reduced coronary calcification. Atherosclerosis. 2008 Jul 19. Published online ahead of print