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Clinical Musings: Stress, Cholesterol & Heart Disease



I find myself drawn to new research about the relationship between heart disease and stress.   Many of my patients lead such fast paced lives.  My clinical experience suggests chronic imbalance between work and play leads to many of the ailments I treat.

A summary article in Medicalnewstoday.com describes another theory linking abnormal cholesterol panels to stress.

The article describes a Spanish study which determined that individuals describing significant job stress had the most significant cholesterol profile abnormalities.

One quote stood out: “Experts have been saying for years that emotional stress is linked to the risk of suffering cardiovascular disease as a result of unhealthy habits such as smoking, an unsuitable diet or leading a sedentary lifestyle, among other factors.”

I work with stressed out patients everyday and this statement probably has some validity.  The faster life becomes the more corners get cut with nutrition, fitness, and healthy habits.  But is this the reason for abnormal lipid panels?

The very scientific answer = Maybe.

I believe the actual “Cause” of heart disease lies not with lipid/cholesterol abnormalities as much as it does with the daily exposure to stress hormones.  Stress hormones raise blood pressure, insulin, and depress immune function.  Sure, crazy fast lifestyles lead to poor choices with nutrition and other lifestyle choices, but just the hormonal response of stress alone may prove the actual cause of heart disease.

Either way, maybe the cure for heart disease has less to do with taking a drug and more with making the conscious decision to address the role stress has in our lives.  IF stress causes lipid abnormalities, maybe therapies designed to improve communication and coping strategies will prove as effective as a statin drug in lower cholesterol?  Of course such a study probably won’t see the light of day due to the complexity involved in trying to manipulate behaviors…but that doesn’t mean that individuals attempting to address stress as a cause of illness might not personally  hit the health jackpot.

Bottom line, I predict that the link between stress and abnormal lipid panels will serve as yet another step towards the medical understanding that primal fight or flight hormones, protracted over time, actually lead to the deterioration of our health at a cellular level.  Furthermore, because cholesterol serves as a building block in all cell membranes and an integral part of hormone structures, we will ultimately view abnormal levels less as the “cause” of heart disease, but rather a symptom of imbalanced stress /repair mechanisms.

What say you?


{ 2 comments… add one }
  • Chris Story May 21, 2013, 1:18 pm

    Somewhat related question…for those of us that are very active (sometimes hyperactive)who also have elevated cholesterol levels, can we deduce that maybe our bodies produce more cholesterol as a repair function and is not as much as a risk factor for those who are not active and do have poor diet, etc? Also, since inflamation is seen as a culprit to heart disease, how does the inflamation from exercise play in the equation?

  • William Curtis May 22, 2013, 1:38 pm

    Great question, research has shown that prolonged high intensity exercise can overwhelm repair mechanisms. High volume, high intensity work can also lead to deterioration in the cardiac function.

    Dr. James O’Keefe (Cardiologist) has researched and lectured extensively on the topic of “over-exercise.” The video is a bit long but will give a fresh perspective on exercise and how it can relate to health.


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