According to the European Health Agency, “a state of stress occurs when there is an imbalance between a person's perception of the constraints imposed on them by their environment and their perception of their own resources for coping with them”, resulting in a feeling of unease.

 

We need to distinguish between stress and the notion of psychosocial stress, which encompasses multiple psychological aspects including stress, anxiety, depression and burnout, as well as social aspects (loneliness, relationship problems) and economic aspects (level of education, social class, income, etc.).

 

Stress is a physiological reaction designed to enable a person to adapt and survive.

But stress also has harmful effects on health, particularly the heart, and on quality of life.

 

Acute stress:

This is usually accompanied by a particularly strong, sudden emotion.

It can be caused by an exceptional circumstance, such as the death of a loved one, an accident, an attack, or a natural disaster such as an earthquake.

 More often than not, however, it's a completely ordinary event, but one that we can experience in a very intense way: an outburst of anger, a family quarrel, a sudden remark at work.

Acute stress can trigger intense emotion, with several physical consequences: heart rate accelerates, blood pressure rises, coronary arteries narrow (coronary spasm), blood volume decreases, blood tends to clot more easily.

This can lead to myocardial infarction, angina pectoris, heart rhythm disorders (atrial fibrillation or ventricular rhythm disorders), venous thrombosis and/or pulmonary embolism (formation of blood clots in the arteries of the lungs). There is then a risk of cardiac arrest (sudden death).

It is estimated that 20 to 40% of sudden deaths are triggered by acute stress.

 

Chronic stress:

The mechanisms of action of stress in cardiology are numerous and contribute to the development of vascular endothelial dysfunction and atheromatous disease, in both coronary and peripheral arteries:

- Activation of inflammation ;

- Blood coagulation disorders;

- Catecholamine secretion;

- Imbalance in sympathetic balance responsible for alteration of heart rate (sinus variability);

 

 Stress acts on numerous risk factors for atheromatous disease:

- Smoking intoxication

- Increased cholesterol levels

- High blood pressure

- Overweight and obesity

- Onset of diabetes

- Destabilization of hypertension or diabetes

- Decreased physical activity and sedentary lifestyle;

 

Stress reduces compliance with medication and favors the onset of a cardiovascular event.