April 24 (HealthDay News) -- In tough economic times, work stress might be hard to avoid. But for people in stressful jobs, it's especially important to take steps to manage the stress in order to protect the heart.
That's because stress not only has been shown to increase the risk of a first heart attack, but also a second.
"Work stress is bad for the heart, because it causes your body to be in a state of high arousal all the time," said Dr. Redford Williams, director of the behavioral medicine research center at Duke University Medical Center in Durham, N.C.
"There are a lot of physiological changes that go with this heightened state -- a raise in blood pressure, increased adrenaline and maybe inflammatory molecules, like CRP are elevated with chronic stress," he explained.
Dr. Matthew Lucks, a cardiologist at Scripps Memorial Hospital in La Jolla, Calif., said that "stress does a lot of damage to the body." As stress quickly raises blood pressure, the amount of resistance in the blood vessels goes up, he said, and this can cause an increase in the atherosclerotic process, meaning the narrowing of blood vessels.
Information on the increased heart attack risk from workplace stress came from a study of nearly 1,000 people, 35 to 59 years old, who returned to work after a heart attack.
Two years later, those who were in jobs with the highest stress levels -- stemming from high demands but low ability for the worker to control the situation or effect change -- had more than double the risk of a recurrent heart attack than people who had the lowest levels of workplace stress. The study was published in the Journal of the American Medical Association.
Lucks pointed out that other research has suggested that a stressful work environment causes a higher risk of heart attack, because it causes people to increase unhealthy behaviors, such as smoking more, drinking more alcohol and exercising less.
Whatever the exact cause, Williams said, it's clear that "people under stress are at high risk for developing heart disease." And, researchers aren't clear just what role stress management techniques might have.
"We don't know for sure whether teaching people to manage job stress better will reduce the risk of heart disease," Williams said. "Smaller studies show that training to reduce stress reduces some of the markers of heart disease, which suggests that we should be able to show a reduction in heart disease risk."
Both Lucks and Williams recommended exercising, because it helps to reduce stress and anxiety levels and improves cardiovascular health. Lucks said that some of his patients try various techniques, such as tai chi, meditation, biofeedback and relaxation exercises, though he said he did not know if the techniques were effective.
Williams and his wife, Virginia, developed their own stress management program, called Williams Life Skills, that teaches people the steps they can take to better control stress. He said they teach people to analyze each situation to see if it's something they can change, if it's something they should change or if it's something that cannot be changed. For situations that can't be changed, people learn how to calm themselves down using meditation, exercise and relaxation," he said.
The bottom line? "People need to be aware that there's a causal link between stress and heart disease," Lucks said. "Stress is a chronic thing, and it's underestimated from a cardiac standpoint."
SOURCES: Matthew Lucks, M.D., cardiologist, Scripps Memorial Hospital, La Jolla, Calif.; Redford Williams, M.D., director, behavioral medicine research center, Duke University Medical Center, Durham, N.C.