essay on stress a silent killer

Stress, The Silent Killer

It’s no secret that stress can wreck your emotional well-being, but chronic stress works quietly behind the scenes to wreak havoc on your physical health, too. Prolonged exposure to sources of stress can quite literally make you sick, and the effects on your body can be life-threatening if left unaddressed.

The Mechanism of Stress

Your body’s  response to stress  is perfectly natural, and it’s evolved over time to keep you safe. In humans and other animals, the physical response to a perceived threat is designed to get the body ready to defend itself or to get away from a dangerous situation.

The stress response first causes a reaction in the brain, where the amygdala–the part of the brain that handles decision-making, memory, and emotional responses–decides whether or not there is a threat and, if there is, alerts the hypothalamus–the part of the brain that regulates hormones–to the danger. The hypothalamus then sends signals to the rest of the body via the hormone epinephrine to trigger a “fight or flight” reaction.

The hormonal signals cause changes throughout the body, including increased blood pressure, rapid breathing, widening of important blood vessels, expansion of airways in the lungs, and release of glucose into the blood stream. These changes, in turn, increase the flow of oxygen and fuel to the muscles and help to sharpen the senses.

As a short-term reaction to danger, the stress response works very well. The stress response kept early humans safe from hungry lions. Unfortunately, modern humans are prone to perceiving a low level of threat in everyday situations over a prolonged period of time, leading to a long-term stress response that is extremely hard on the body. A frustrating daily commute, financial strain, relationship disagreements, or caring for an ailing loved one are all situations that can trigger the stress response and keep it going for weeks, months, or even years at a time.

Stress and Your Body

Even in the short term, stress can have detrimental effects on your body. Left unchecked over the course of years, however, chronic stress can lead to conditions that are extremely serious.

Short-term physical effects of stress include:

• Headaches, or other aches and pains.  Changes in your circulatory system can cause distress in all areas of your body. Stress-induced muscle tension can also lead to muscular aches.
• Digestive or intestinal distress.  Studies have shown that stress changes the way your gastrointestinal system processes food, and chronic stress can also cause changes in appetite.
• Insomnia or other sleep-pattern disruptions.
• Changes in sex drive.
• Increased susceptibility to infections.  The stress response impedes the immune system, increasing the chance that you’ll get colds or other common infections.

Over the long term, the cumulative effect of these smaller problems can produce chronic conditions, including:

• High blood pressure
• Heart disease, heart attacks or strokes
• Diabetes, obesity or eating disorders
• Impotence or other sexual dysfunction
• Gastrointestinal conditions such as ulcerative colitis, Crohn’s disease, or other inflammatory bowel diseases

The video below offers a discussion of how stress affects your body, as well as some tips for recognizing when you’re at risk for stress-related health problems:

Stress and Your Brain

Chronic stress is not just hard on your body; it  taxes your mind , as well. Stress paves the way for emotional and mental conditions like irritability, depression, and anxiety. It also impairs your fundamental cognitive functions thanks to the changes it makes in the structure and function of your brain.

The brain-related effects of stress include:

• Memory problems.  Chronic stress can make your amygdala and hippocampus less efficient and less able to produce new nerve tissue. It may even reduce the size of the hippocampus. These changes can lead to decreased spatial and verbal memory abilities.
• Learning and cognition problems.  The changes in the amygdala and hippocampus can result in decreased decision-making and processing abilities, difficulty learning, and susceptibility to behavioral and mood disorders.

Managing Stress

Aside from removing the source of your stress altogether, there are other ways that you can manage your daily stress level and reduce the impact that stress has on your body and mind.

• Physical activity.  Studies have shown that physical activity helps to reduce the impact of chronic stress by improving sleep habits, reducing physical tension, and stabilizing mood.
• Relaxation activities.  Activities such as meditation, yoga, breathing techniques, or massage can significantly reduce stress, but less formal pleasurable activities such as mentally-stimulating hobbies can help, too.
• Social activity.  Being with friends and family in an enjoyable setting is a proven stress reducer.
• Good nutrition and sleep habits.  A complete, balanced diet and an adequate amount of sleep are key in keeping your immune system strong and helping your body to resist the damaging effects of stress.
• Substance avoidance.  Substances such as tobacco, alcohol, caffeine and other drugs can exacerbate the effects of stress and increase your risk of developing long-term health conditions.
• Professional help.  Don’t be afraid to seek professional help when stress is a chronic problem. A therapist or counselor can give you strategies for avoiding and moderating the sources of your stress, as well as managing your response to stressful situations. Also, don’t hesitate to seek immediate medical assistance if you experience physical symptoms such as chest pain, dizziness, or shortness of breath.

Chronic stress can be a killer, but only if you let it be. You’ll never be able to eliminate all stress from your life, but with the proper management techniques and proactive strategies, you can prevent it from doing long-term harm.

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Stress: The Silent Killer: How to Recognize and Manage it Before it's Too Late

Stress : The Silent Killer: How to Recognize and Manage it Before it's Too Late

Stress is a silent killer that can have a significant impact on our physical and mental well-being. It is a natural response to the demands and pressures of daily life, but when left unmanaged, it can lead to serious health problems such as heart disease, depression , and anxiety . Recognizing the signs of stress and taking steps to manage it is essential for maintaining good health and overall well-being. In this article, we will take a closer look at what stress is, its physical and emotional effects, and how to recognize the signs of stress . We will also discuss various techniques and strategies for managing stress and maintaining your mental wellness.

Understanding Stress

What is stress .

Stress is a natural response to challenging or demanding situations. It is the body's way of preparing to deal with potential threats or challenges. When we experience stress , our bodies release hormones such as adrenaline and cortisol, which prepare us for a "fight or flight" response. This response can be helpful in certain situations, such as when we need to react quickly to danger. However, when stress is chronic, it can have a negative impact on our physical and mental health .

The physical and emotional effects of stress

Stress can manifest itself in a variety of ways. Physically , stress can cause headaches , fatigue, muscle tension, and sleep disturbances. It can also affect our immune system, making us more susceptible to illnesses. Emotionally, stress can cause feelings of anxiety , depression , and irritability. It can also lead to changes in our behavior, such as overeating or not eating enough, substance abuse , and social withdrawal. Chronic stress can also increase the risk of developing serious health conditions such as heart disease and diabetes. It's important to recognize the signs of stress and take steps to manage it effectively before it becomes a major problem.

Recognizing the Signs of Stress

Common symptoms of stress.

Stress can manifest in various ways, both physically and emotionally. Some common symptoms of stress include:

• Headaches and migraines
• Insomnia or difficulty sleeping
• Fatigue and low energy
• Digestive issues, such as stomach aches or indigestion
• Anxiety and depression
• Irritability and mood swings
• Loss of appetite or overeating
• Difficulty concentrating or memory problems

How to identify when stress is becoming a problem

While some stress is normal and can even be beneficial, excessive stress can have negative consequences on both physical and mental health . To identify when stress is becoming a problem, consider the following:

The duration of your stress : Is it a short-term response to a specific event or situation, or has it been ongoing for an extended period? The intensity of your stress : Is it manageable or overwhelming? The impact of your stress on daily life: Is it impacting your relationships, work, or daily activities? Your ability to cope with stress : Are you able to effectively manage and reduce your stress , or is it overwhelming you?

If you experience any of these signs, it may be time to seek help from a professional or make changes to your lifestyle to manage your stress .

Please note, these are general symptoms, for any severe case, consult with a doctor before taking any steps

Managing Stress

Lifestyle changes for stress management.

Making changes to your daily habits and routines can greatly reduce stress and improve overall mental and physical well-being. Some effective lifestyle changes include:

Exercise and physical activity

Regular exercise has been shown to decrease stress levels, improve mood, and increase overall energy levels. Aim for at least 30 minutes of moderate-intensity exercise , such as brisk walking, jogging, cycling, or swimming, at least 3 times a week.

Eating a healthy diet

A well-balanced diet can improve overall physical health and reduce stress levels. Eating nutrient-dense foods, such as fruits and vegetables, lean proteins, and whole grains, can help to keep energy levels up and reduce feelings of anxiety and depression .

Getting enough sleep

Sleep is essential for physical and mental well-being, and lack of sleep can greatly exacerbate stress levels. Aim for 7-9 hours of sleep per night, and establish a consistent sleep routine, going to bed and waking up at the same time each day.

Managing time and setting boundaries

Being overwhelmed with responsibilities can greatly increase stress levels. To manage time and reduce stress , prioritize tasks and set boundaries for yourself and others. Learn to say no to unnecessary commitments, and take regular breaks throughout the day to recharge.

Stress -reducing techniques

There are various techniques that can help to manage and reduce stress , including:

Mindfulness and meditation

Mindfulness and meditation can help to focus the mind and reduce feelings of anxiety and stress . Practicing mindfulness techniques, such as deep breathing and visualization, can help to calm the mind and reduce feelings of stress . H4: Yoga and tai chi

Yoga and tai chi are gentle forms of exercise that can help to reduce stress and improve overall physical and mental well-being. These practices involve a combination of physical movement, breathing, and meditation , which can help to reduce stress and improve overall mood. H4: Deep breathing exercises

Simple deep breathing exercises can be done anywhere, anytime and can greatly help to reduce feelings of stress and anxiety . Taking slow, deep breaths and focusing on the breath can help to calm the mind and reduce feelings of stress . H4: Journaling and creative expression

Journaling and creative expression can be a great way to process and release feelings of stress . Writing down thoughts and feelings, or engaging in a creative activity, such as painting or drawing, can be a great way to relieve stress and improve overall mental well-being.

Professional help for stress management

If stress is becoming a problem and is impacting daily life, it may be time to seek professional help. Some options include:

Therapy and counseling

A qualified therapist or counselor can help to identify the root causes of stress and provide coping mechanisms and strategies for managing stress .

Medication options

Medication may be prescribed to help manage symptoms of stress , such as anxiety or depression . However, it's always better to consult with a doctor before taking any medication. In conclusion, stress can be a silent killer that can have severe consequences on both physical and mental health . By recognizing the signs of stress and taking action to manage and reduce stress , individuals can improve overall well-being and prevent negative consequences.

The importance of recognizing and managing stress

Stress is a silent killer that can have a significant impact on our physical and mental health . It is essential to recognize the signs of stress and take action to manage it before it becomes a problem. Chronic stress can lead to a variety of health issues, including heart disease, anxiety , and depression . Recognizing the signs of stress and taking steps to manage it can help improve your overall well-being and prevent long-term health problems.

Taking action to improve your mental and physical well-being

Managing stress is essential for maintaining good mental and physical health. There are many ways to reduce stress and improve overall well-being. These include lifestyle changes such as exercise , eating a healthy diet, and getting enough sleep . Stress -reducing techniques such as mindfulness , meditation , and yoga can also be beneficial. Additionally, professional help such as therapy and counseling can be an effective way to manage stress . By taking action to manage stress , you can improve your overall well-being and prevent long-term health problems.

This is a wonderful list of ways to combat stress. I find mindfulness and meditation to be my favorite.

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The impact of stress on body function: A review

Habib yaribeygi.

1 Neurosciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Yunes Panahi

2 Clinical Pharmacy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran

Hedayat Sahraei

Thomas p. johnston.

3 Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, Missouri, USA

Amirhossein Sahebkar

4 Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Any intrinsic or extrinsic stimulus that evokes a biological response is known as stress. The compensatory responses to these stresses are known as stress responses. Based on the type, timing and severity of the applied stimulus, stress can exert various actions on the body ranging from alterations in homeostasis to life-threatening effects and death. In many cases, the pathophysiological complications of disease arise from stress and the subjects exposed to stress, e.g. those that work or live in stressful environments, have a higher likelihood of many disorders. Stress can be either a triggering or aggravating factor for many diseases and pathological conditions. In this study, we have reviewed some of the major effects of stress on the primary physiological systems of humans.

Abbreviations

ACTH: Adrenocorticotropic hormone

CNS: Central nervous system

CRH: Corticotropin releasing hormone

GI: Gastrointestinal

LTP: Long-term potentiation

NMDA : N-methyl-D-aspartate

VTA: Ventral tegmental area

Stress and the Brain Function Complications

For a long time, researchers suggested that hormones have receptors just in the peripheral tissues and do not gain access to the central nervous system (CNS) (Lupien and Lepage, 2001[ 63 ]). However, observations have demonstrated the effect of anti-inflammatory drugs (which are considered synthetic hormones) on behavioral and cognitive disorders and the phenomenon called “Steroid psychosis” (Clark et al., 1952[ 16 ]). In the early sixties, neuropeptides were recognized as compounds devoid of effects on the peripheral endocrine system. However, it was determined that hormones are able to elicit biological effects on different parts of the CNS and play an important role in behavior and cognition (De Kloet, 2000[ 22 ]). In 1968, McEven suggested for the first time that the brain of rodents is capable of responding to glucocorticoid (as one of the operators in the stress cascade). This hypothesis that stress can cause functional changes in the CNS was then accepted (McEwen et al., 1968[ 74 ]). From that time on, two types of corticotropic receptors (glucocorticosteroids and mineralocorticoids) were recognized (de Kloet et al., 1999[ 23 ]). It was determined that the affinity of glucocorticosteroid receptors to cortisol and corticosterone was about one tenth of that of mineralocorticoids (de Kloet et al., 1999[ 23 ]). The hippocampus area has both types of receptors, while other points of the brain have only glucocorticosteroid receptors (de Kloet et al., 1999[ 23 ]).

The effects of stress on the nervous system have been investigated for 50 years (Thierry et al., 1968[ 115 ]). Some studies have shown that stress has many effects on the human nervous system and can cause structural changes in different parts of the brain (Lupien et al., 2009[ 65 ]). Chronic stress can lead to atrophy of the brain mass and decrease its weight (Sarahian et al., 2014[ 100 ]). These structural changes bring about differences in the response to stress, cognition and memory (Lupien et al., 2009[ 65 ]). Of course, the amount and intensity of the changes are different according to the stress level and the duration of stress (Lupien et al., 2009[ 65 ]). However, it is now obvious that stress can cause structural changes in the brain with long-term effects on the nervous system (Reznikov et al., 2007[ 89 ]). Thus, it is highly essential to investigate the effects of stress on different aspects of the nervous system (Table 1 (Tab. 1) ; References in Table 1: Lupien et al., 2001[ 63 ]; Woolley et al., 1990[ 122 ]; Sapolsky et al., 1990[ 99 ]; Gould et al., 1998[ 35 ]; Bremner, 1999[ 10 ]; Seeman et al., 1997[ 108 ]; Luine et al., 1994[ 62 ]; Li et al., 2008[ 60 ]; Scholey et al., 2014[ 101 ]; Borcel et al., 2008[ 9 ]; Lupien et al., 2002[ 66 ]).

Stress and Memory

Memory is one of the important functional aspects of the CNS and it is categorized as sensory, short term, and long-term. Short term memory is dependent on the function of the frontal and parietal lobes, while long-term memory depends on the function of large areas of the brain (Wood et al., 2000[ 121 ]). However, total function of memory and the conversion of short term memory to long-term memory are dependent on the hippocampus; an area of the brain that has the highest density of glucocorticosteroid receptors and also represents the highest level of response to stress (Scoville and Milner, 1957[ 107 ]; Asalgoo et al., 2015[ 1 ]). Therefore, during the past several decades, the relationship between the hippocampus and stress have been hotly debated (Asalgoo et al., 2015[ 1 ]; Lupien and Lepage, 2001[ 63 ]). In 1968, it was proven that there were cortisol receptors in the hippocampus of rats (McEwen et al., 1968[ 74 ]). Later, in 1982, by using specific agonists of glucocorticosteroid and mineralocorticoid receptors, the existence of these two receptors in the brain and hippocampus area of rats was proven (Veldhuis et al., 1982[ 119 ]). It should also be noted that the amygdala is very important to assessing the emotional experiences of memory (Roozendaal et al., 2009[ 91 ]).

The results of past studies have demonstrated the effect of stress on the process of memory (Ghodrat et al., 2014[ 32 ]). Various studies have shown that stress can cause functional and structural changes in the hippocampus section of the brain (McEwen, 1999[ 72 ]). These structural changes include atrophy and neurogenesis disorders (Lupien and Lepage, 2001[ 63 ]). Also, chronic stress and, consequently, an increase in plasma cortisol, leads to a reduction in the number of dendritic branches (Woolley et al., 1990[ 122 ]) and the number of neurons (Sapolsky et al., 1990[ 99 ]), as well as structural changes in synaptic terminals (Sapolsky et al., 1990[ 99 ]) and decreased neurogenesis in the hippocampus tissue (Gould et al., 1998[ 35 ]). Glucocorticosteroids can induce these changes by either effecting the cellular metabolism of neurons (Lawrence and Sapolsky, 1994[ 58 ]), or increasing the sensitivity of hippocampus cells to stimulatory amino acids (Sapolsky and Pulsinelli, 1985[ 98 ]) and/or increasing the level of extracellular glutamate (Sapolsky and Pulsinelli, 1985[ 98 ]).

High concentrations of stress hormones can cause declarative memory disorders (Lupien and Lepage, 2001[ 63 ]). Animal studies have shown that stress can cause a reversible reduction in spatial memory as a result of atrophy of the hippocampus (Luine et al., 1994[ 62 ]). In fact, high plasma concentrations of glucocorticosteroids for extended periods of time can cause atrophy of the hippocampus leading to memory disorders (Issa et al., 1990[ 45 ]). Additionally, people with either Cushing's syndrome (with an increased secretion of glucocorticosteroids), or people who receive high dosages of exogenous synthetic anti-inflammatory drugs, are observed to have atrophy of the hippocampus and associated memory disorders (Ling et al., 1981[ 61 ]). MRI images taken from the brains of people with post-traumatic stress disorder (PTSD) have demonstrated a reduction in the volume of the hippocampus along with neurophysiologic effects such as a weak verbal memory (Bremner, 1999[ 10 ]). Several human studies have suggested that even common therapeutic doses of glucocorticosteroids and dexamethasone can cause problems with explicit memory (Keenan et al., 1995[ 49 ]; Kirschbaum et al., 1996[ 53 ]). Thus, there is an inverse relationship between the level of cortisol and memory (Ling et al., 1981[ 61 ]), such that increasing levels of plasma cortisol following prolonged stress leads to a reduction in memory (Kirschbaum et al., 1996[ 53 ]), which improves when the level of plasma cortisol decreases (Seeman et al., 1997[ 108 ]).

Stress also has negative effects on learning. Results from hippocampus-dependent loading data demonstrate that subjects are not as familiar with a new environment after having been exposed to a new environment (Bremner, 1999[ 10 ]). Moreover, adrenal steroids lead to alteration in long-term potentiation (LTP), which is an important process in memory formation (Bliss and Lømo, 1973[ 7 ]).

Two factors are involved in the memory process during stress. The first is noradrenaline, which creates emotional aspects of memories in the basolateral amygdala area (Joëls et al., 2011[ 47 ]). Secondly, this process is facilitated by corticosteroids. However, if the release of corticosteroids occurs a few hours earlier, it causes inhibition of the amygdala and corresponding behaviors (Joëls et al., 2011[ 47 ]). Thus, there is a mutual balance between these two hormones for creating a response in the memory process (Joëls et al., 2011[ 47 ]).

Stress does not always affect memory. Sometimes, under special conditions, stress can actually improve memory (McEwen and Lupien, 2002[ 71 ]). These conditions include non-familiarity, non-predictability, and life-threatening aspects of imposed stimulation. Under these specific conditions, stress can temporarily improve the function of the brain and, therefore, memory. In fact, it has been suggested that stress can sharpen memory in some situations (Schwabe et al., 2010[ 105 ]). For example, it has been shown that having to take a written examination can improve memory for a short period of time in examination participants. Interestingly, this condition is associated with a decrease in the level of cortisol in the saliva (Vedhara et al., 2000[ 118 ]). Other studies have shown that impending stress before learning occurs can also lead to either an increase in the power of memory (Domes et al., 2002[ 27 ]; Schwabe et al., 2008[ 102 ]), or decrease in the capacity for memory (Diamond et al., 2006[ 26 ]; Kirschbaum et al., 1996[ 53 ]). This paradox results from the type of imposed stress and either the degree of emotional connection to the stressful event (Payne et al., 2007[ 83 ]; Diamond et al., 2007[ 25 ]), or the period of time between the imposing stress and the process of learning (Diamond et al., 2007[ 25 ]).

The process of strengthening memory is usually reinforced after stress (Schwabe et al., 2012[ 103 ]). Various studies on animal and human models have shown that administration of either glucocorticosteroids, or stress shortly after learning has occurred facilitates memory (Schwabe et al., 2012[ 103 ]). Also, it has been shown that glucocorticosteroids (not mineralocorticoids) are necessary to improve learning and memory (Lupien et al., 2002[ 66 ]). However, the retrieval of events in memory after exposure to stress will be decreased (Schwabe et al., 2012[ 103 ]), which may result from the competition of updated data for storage in memory in a stressful state (de Kloet et al., 1999[ 23 ]). Some investigations have shown that either exposure to stress, or injection of glucocorticosteroids before a test to assess retention, decreases the power of memory in humans and rodents (Schwabe and Wolf, 2009[ 104 ]).

In summary, it has been concluded that the effect of stress on memory is highly dependent on the time of exposure to the stressful stimulus and, in terms of the timing of the imposed stress, memory can be either better or worse (Schwabe et al., 2012[ 103 ]). Moreover, recent studies have shown that using a specific-timed schedule of exposure to stress not only affects hippocampus-dependent memory, but also striatum-dependent memory, which highlights the role of timing of the imposed stressful stimulus (Schwabe et al., 2010[ 105 ]).

Stress, Cognition and Learning

Cognition is another important feature of brain function. Cognition means reception and perception of perceived stimuli and its interpretation, which includes learning, decision making, attention, and judgment (Sandi, 2013[ 95 ]). Stress has many effects on cognition that depend on its intensity, duration, origin, and magnitude (Sandi, 2013[ 95 ]). Similar to memory, cognition is mainly formed in the hippocampus, amygdala, and temporal lobe (McEwen and Sapolsky, 1995[ 73 ]). The net effect of stress on cognition is a reduction in cognition and thus, it is said that any behavioral steps undertaken to reduce stress leads to increase in cognition (Scholey et al., 2014[ 101 ]). In fact, stress activates some physiological systems, such as the autonomic nervous system, central neurotransmitter and neuropeptide system, and the hypothalamus-pituitary-adrenal axis, which have direct effects on neural circuits in the brain involved with data processing (Sandi, 2013[ 95 ]). Activation of stress results in the production and release of glucocorticosteroids. Because of the lipophilic properties of glucocorticosteroids, they can diffuse through the blood-brain barrier and exert long-term effects on processing and cognition (Sandi, 2013[ 95 ]).

It appears that being exposed to stress can cause pathophysiologic changes in the brain, and these changes can be manifested as behavioral, cognitive, and mood disorders (Li et al., 2008[ 60 ]). In fact, studies have shown that chronic stress can cause complications such as increased IL-6 and plasma cortisol, but decreased amounts of cAMP responsive element binding protein and brain-derived neurotrophic factor (BDNF), which is very similar to what is observed in people with depression and mood disorders that exhibit a wide range of cognitive problems (Song et al., 2006[ 114 ]). Additionally, the increased concentrations of inflammatory factors, like interleukins and TNF-α (which play an important role in creating cognitive disorders), proves a physiologic relationship between stress and mood-based cognitive disorders (Solerte et al., 2000[ 113 ]; Marsland et al., 2006[ 68 ]; Li et al., 2008[ 60 ]). Studies on animals suggest that cognitive disorders resulting from stress are created due to neuroendocrine and neuroamine factors and neurodegenerative processes (Li et al., 2008[ 60 ]). However, it should be noted that depression may not always be due to the over activation of the physiological-based stress response (Osanloo et al., 2016[ 81 ]).

Cognitive disorders following exposure to stress have been reported in past studies (Lupien and McEwen, 1997[ 64 ]). Stress has effects on cognition both acutely (through catecholamines) and chronically (through glucocorticosteroids) (McEwen and Sapolsky, 1995[ 73 ]). Acute effects are mainly caused by beta-adrenergic effects, while chronic effects are induced in a long-term manner by changes in gene expression mediated by steroids (McEwen and Sapolsky, 1995[ 73 ]). In general, many mechanisms modulate the effects of stress on cognition (McEwen and Sapolsky, 1995[ 73 ]; Mendl, 1999[ 75 ]). For instance, adrenal steroids affect the function of the hippocampus during cognition and memory retrieval in a biphasic manner (McEwen and Sapolsky, 1995[ 73 ]). In chronic stress, these steroids can destroy neurons with other stimulatory neurotransmitters (Sandi, 2013[ 95 ]). Exposure to stress can also cause disorders in hippocampus-related cognition; specifically, spatial memory (Borcel et al., 2008[ 9 ]; Sandi et al., 2003[ 96 ]). Additionally, stress can halt or decrease the genesis of neurons in the dentate gyrus area of the hippocampus (this area is one of the limited brain areas in which neurogenesis occurs in adults) (Gould and Tanapat, 1999[ 34 ]; Köhler et al., 2010[ 54 ]). Although age is a factor known to affect cognition, studies on animals have demonstrated that young rats exposed to high doses of adrenal steroids show the same level of decline in their cognition as older adult animals with normal plasma concentrations of glucocorticoids (Landfield et al., 1978[ 57 ]). Also, a decrease in the secretion of glucocorticosteroids causes preservation of spatial memory in adults and has also been shown to have neuroprotective effects (Montaron et al., 2006[ 78 ]). Other studies have shown that stress (or the injection of adrenal steroids) results in varied effects on cognition. For instance, injection of hydrocortisone at the time of its maximum plasma concentration (in the afternoon) leads to a decrease in reaction time and improves cognition and memory (Lupien et al., 2002[ 66 ]).

In summary, the adverse effects of stress on cognition are diverse and depend on the type, timing, intensity, and duration (Sandi, 2013[ 95 ]). Generally, it is believed that mild stress facilitates an improvement in cognitive function, especially in the case of virtual or verbal memory. However, if the intensity of stress passes beyond a predetermined threshold (which is different in each individual), it causes cognitive disorders, especially in memory and judgment. The disruption to memory and judgment is due to the effects of stress on the hippocampus and prefrontal cortex (Sandi, 2013[ 95 ]). Of course, it must be realized that factors like age and gender may also play a role in some cognitive disorders (Sandi, 2013[ 95 ]). Importantly, it should be emphasized that different people may exhibit varied responses in cognition when exposed to the very same stressful stimulus (Hatef et al., 2015[ 39 ]).

Stress and Immune System Functions

The relationship between stress and the immune system has been considered for decades (Khansari et al., 1990[ 50 ]; Dantzer and Kelley, 1989[ 21 ]). The prevailing attitude between the association of stress and immune system response has been that people under stress are more likely to have an impaired immune system and, as a result, suffer from more frequent illness (Khansari et al., 1990[ 50 ]). Also, old anecdotes describing resistance of some people to severe disease using the power of the mind and their thought processes, has promoted this attitude (Khansari et al., 1990[ 50 ]). In about 200 AC, Aelius Galenus (Galen of Pergamon) declared that melancholic women (who have high levels of stress and, thus, impaired immune function) are more likely to have cancer than women who were more positive and exposed to less stress (Reiche et al., 2004[ 88 ]). This may be the first recorded case about the relationship between the immune system and stress. In an old study in the early 1920's, researchers found that the activity of phagocytes in tuberculosis decreased when emotional stress was induced. In fact, it was also suggested that living with stress increases the risk of tuberculosis by suppressing the immune system (Ishigami, 1919[ 44 ]). Following this study, other researchers suggested that the probability of disease appearance increases following a sudden, major, and extremely stressful life style change (Holmes and Rahe, 1967[ 41 ]; Calabrese et al., 1987[ 12 ]).

Over the past several decades, there have been many studies investigating the role of stress on immune system function (Dantzer and Kelley, 1989[ 21 ]; Segerstrom and Miller, 2004[ 109 ]). These studies have shown that stress mediators can pass through the blood-brain barrier and exert their effects on the immune system (Khansari et al., 1990[ 50 ]). Thus, the effect of stress on the immune system is now an accepted relationship or association.

Stress can affect the function of the immune system by modulating processes in the CNS and neuroendocrine system (Khansari et al., 1990[ 50 ]; Kiecolt-Glaser and Glaser, 1991[ 51 ]). Following stress, some neuroendocrine and neural responses result in the release of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and other stress mediators (Carrasco and Van de Kar, 2003[ 13 ]). However, evidence suggests that the lymphatic system, which is a part of the immune system, also plays a role in releasing these mediators (Khansari et al., 1990[ 50 ]). For instance, thymus peptides, such as thymopentine, thymopoietin, and thymosin fraction-5, cause an increase in ACTH production (Goya et al., 1993[ 36 ]). Additionally, the existence of CRH in thymus has been proven (Redei, 1992[ 87 ]). It has also been proven that interleukin-1 released from phagocytes has a role in ACTH secretion (Berkenbosch et al., 1987[ 4 ]). On the other hand, natural or synthetic glucocorticosteroids (which are the final stress operators) are known as anti-inflammatory drugs and immune suppressants and their role in the inhibition of lymphocytes and macrophages has been demonstrated as well (Elenkov et al., 1999[ 28 ]; Reiche et al., 2004[ 88 ]). Moreover, their role in inhibiting the production of cytokines and other immune mediators and decreasing their effect on target cells during exposure to stress has also been determined (Reiche et al., 2004[ 88 ]).

In addition to adrenal steroids, other hormones are affected during stress. For example, the secretion of growth hormone will be halted during severe stress. A study showed that long-term administration of CRH into the brain ventricles leads to a cessation in the release of growth hormone (Rivier and Vale, 1985[ 90 ]). Stress also causes the release of opioid peptides to be changed during the time period over which the person is exposed to stress (McCarthy et al., 2001[ 70 ]). In fact, stress modifies the secretion of hormones that play a critical role in the function of the immune system (Khansari et al., 1990[ 50 ]). To date, it has been shown that various receptors for a variety of hormones involved in immune system function are adversely affected by stress. For example, ACTH, vasoactive intestinal peptide (VIP), substance P, growth hormone, prolactin, and steroids all have receptors in various tissues of the immune system and can modulate its function (De la Fuente et al., 1996[ 24 ]; Gala, 1991[ 30 ]; Mantyh, 1991[ 67 ]). In addition, active immune cells are also able to secrete several hormones; thus, some researchers believe that these hormones, as mediators of immune system, play a significant role in balancing its function (Blalock et al., 1985[ 6 ]).

Severe stress can lead to malignancy by suppressing the immune system (Reiche et al., 2004[ 88 ]). In fact, stress can decrease the activity of cytotoxic T lymphocytes and natural killer cells and lead to growth of malignant cells, genetic instability, and tumor expansion (Reiche et al., 2004[ 88 ]). Studies have shown that the plasma concentration of norepinephrine, which increases after the induction stress, has an inverse relationship with the immune function of phagocytes and lymphocytes (Reiche et al., 2004[ 88 ]). Lastly, catecholamines and opioids that are released following stress have immune-suppressing properties (Reiche et al., 2004[ 88 ]).

Stress and the Function of the Cardiovascular System

The existence of a positive association between stress and cardiovascular disease has been verified (Rozanski et al., 1999[ 93 ]). Stress, whether acute or chronic, has a deleterious effect on the function of the cardiovascular system (Rozanski et al., 1999[ 93 ]; Kario et al., 2003[ 48 ]; Herd, 1991[ 40 ]). The effects of stress on the cardiovascular system are not only stimulatory, but also inhibitory in nature (Engler and Engler, 1995[ 29 ]). It can be postulated that stress causes autonomic nervous system activation and indirectly affects the function of the cardiovascular system (Lazarus et al., 1963[ 59 ]; Vrijkotte et al., 2000[ 120 ]). If these effects occur upon activation of the sympathetic nervous system, then it mainly results in an increase in heart rate, strength of contraction, vasodilation in the arteries of skeletal muscles, a narrowing of the veins, contraction of the arteries in the spleen and kidneys, and decreased sodium excretion by the kidneys (Herd, 1991[ 40 ]). Sometimes, stress activates the parasympathetic nervous system (Pagani et al., 1991[ 82 ]). Specifically, if it leads to stimulation of the limbic system, it results in a decrease, or even a total stopping of the heart-beat, decreased contractility, reduction in the guidance of impulses by the heart stimulus-transmission network, peripheral vasodilatation, and a decline in blood pressure (Cohen et al., 2000[ 17 ]). Finally, stress can modulate vascular endothelial cell function and increase the risk of thrombosis and ischemia, as well as increase platelet aggregation (Rozanski et al., 1999[ 93 ]).

The initial effect of stress on heart function is usually on the heart rate (Vrijkotte et al., 2000[ 120 ]). Depending upon the direction of the shift in the sympatho-vagal response, the heart beat will either increase or decrease (Hall et al., 2004[ 38 ]). The next significant effect of stress on cardiovascular function is blood pressure (Laitinen et al., 1999[ 56 ]). Stress can stimulate the autonomic sympathetic nervous system to increase vasoconstriction, which can mediate an increase in blood pressure, an increase in blood lipids, disorders in blood clotting, vascular changes, atherogenesis; all, of which, can cause cardiac arrhythmias and subsequent myocardial infarction (Rozanski et al., 1999[ 93 ]; Vrijkotte et al., 2000[ 120 ]; Sgoifo et al., 1998[ 111 ]). These effects from stress are observed clinically with atherosclerosis and leads to an increase in coronary vasoconstriction (Rozanski et al., 1999[ 93 ]). Of course, there are individual differences in terms of the level of autonomic-based responses due to stress, which depends on the personal characteristics of a given individual (Rozanski et al., 1999[ 93 ]). Thus, training programs for stress management are aimed at reducing the consequences of stress and death resulting from heart disease (Engler and Engler, 1995[ 29 ]). In addition, there are gender-dependent differences in the cardiovascular response to stress and, accordingly, it has been estimated that women begin to exhibit heart disease ten years later that men, which has been attributed to the protective effects of the estrogen hormone (Rozanski et al., 1999[ 93 ]).

Studies have shown that psychological stress can cause alpha-adrenergic stimulation and, consequently, increase heart rate and oxygen demand (Rozanski et al., 1998[ 92 ], 1999[ 93 ]; Jiang et al., 1996[ 46 ]). As a result, coronary vasoconstriction is enhanced, which may increase the risk of myocardial infarction (Yeung et al., 1991[ 124 ]; Boltwood et al., 1993[ 8 ]; Dakak et al., 1995[ 20 ]). Several studies have demonstrated that psychological stress decreases the microcirculation in the coronary arteries by an endothelium-dependent mechanism and increases the risk of myocardial infarction (Dakak et al., 1995[ 20 ]). On the other hand, mental stress indirectly leads to potential engagement in risky behaviors for the heart, such as smoking, and directly leads to stimulation of the neuroendocrine system as part of the autonomic nervous system (Hornstein, 2004[ 43 ]). It has been suggested that severe mental stress can result in sudden death (Pignalberi et al., 2002[ 84 ]). Generally, stress-mediated risky behaviors that impact cardiovascular health can be summarized into five categories: an increase in the stimulation of the sympathetic nervous system, initiation and progression of myocardial ischemia, development of cardiac arrhythmias, stimulation of platelet aggregation, and endothelial dysfunction (Wu, 2001[ 123 ]).

Stress and Gastrointestinal Complications

The effects of stress on nutrition and the gastrointestinal (GI) system can be summarized with two aspects of GI function.

First, stress can affect appetite (Bagheri Nikoo et al., 2014[ 2 ]; Halataei et al., 2011[ 37 ]; Ranjbaran et al., 2013[ 86 ]). This effect is related to involvement of either the ventral tegmental area (VTA), or the amygdala via N-methyl-D-aspartate (NMDA) glutamate receptors (Nasihatkon et al., 2014[ 80 ]; Sadeghi et al., 2015[ 94 ]). However, it should also be noted that nutrition patterns have effects on the response to stress (Ghanbari et al., 2015[ 31 ]), and this suggests a bilateral interaction between nutrition and stress.

Second, stress adversely affects the normal function of GI tract. There are many studies concerning the effect of stress on the function of the GI system (Söderholm and Perdue, 2001[ 112 ]; Collins, 2001[ 18 ]). For instance, studies have shown that stress affects the absorption process, intestinal permeability, mucus and stomach acid secretion, function of ion channels, and GI inflammation (Collins, 2001[ 18 ]; Nabavizadeh et al., 2011[ 79 ]). Stress also increases the response of the GI system to inflammation and may reactivate previous inflammation and accelerate the inflammation process by secretion of mediators such as substance P (Collins, 2001[ 18 ]). As a result, there is an increase in the permeability of cells and recruitment of T lymphocytes. Lymphocyte aggregation leads to the production of inflammatory markers, activates key pathways in the hypothalamus, and results in negative feedback due to CRH secretion, which ultimately results in the appearance of GI inflammatory diseases (Collins, 2001[ 18 ]). This process can reactivate previous silent colitis (Million et al., 1999[ 76 ]; Qiu et al., 1999[ 85 ]). Mast cells play a crucial role in stress-induced effects on the GI system, because they cause neurotransmitters and other chemical factors to be released that affect the function of the GI system (Konturek et al., 2011[ 55 ]).

Stress can also alter the functional physiology of the intestine (Kiliaan et al., 1998[ 52 ]). Many inflammatory diseases, such as Crohn's disease and other ulcerative-based diseases of the GI tract, are associated with stress (Hommes et al., 2002[ 42 ]). It has been suggested that even childhood stress can lead to these diseases in adulthood (Schwartz and Schwartz, 1983[ 106 ]). Irritable bowel syndrome, which is a disease with an inflammatory origin, is highly related to stress (Gonsalkorale et al., 2003[ 33 ]). Studies on various animals suggest the existence of inflammatory GI diseases following induction of severe stress (Qiu et al., 1999[ 85 ]; Collins et al., 1996[ 19 ]). Additionally, pharmacological interventions, in an attempt to decrease the response of CRH to stress, have been shown to result in an increase in GI diseases in rats (Million et al., 1999[ 76 ]).

Altering the permeability of the mucosal membrane by perturbing the functions of mucosal mast cells may be another way that stress causes its effects on the GI system, since this is a normal process by which harmful and toxic substances are removed from the intestinal lumen (Söderholm and Perdue, 2001[ 112 ]). Also, stress can both decrease the removal of water from the lumen, as well as induce sodium and chloride secretion into the lumen. This most likely occurs by increasing the activity of the parasympathetic nervous system (Barclay and Turnberg, 1987[ 3 ]). Moreover, physical stress, such as trauma or surgery, can increase luminal permeability (Söderholm and Perdue, 2001[ 112 ]) (Table 2 (Tab. 2) ; References in Table 2: Halataei et al., 2011[ 37 ]; Ranjbaran et al., 2013[ 86 ]; Mönnikes et al., 2001[ 77 ]; Collins, 2001[ 18 ]; Nabavizadeh et al., 2011[ 79 ]; Barclay and Turnberg, 1987[ 3 ]; Million et al., 1999[ 76 ]; Gonsalkorale et al., 2003[ 33 ]).

Stress also affects movement of the GI tract. In this way, it prevents stomach emptying and accelerates colonic motility (Mönnikes et al., 2001[ 77 ]). In the case of irritable bowel syndrome, stress increases the movement (contractility and motility) of the large intestine (Mönnikes et al., 2001[ 77 ]). Previous studies have revealed that CRH increases movement in the terminal sections of the GI tract and decreases the movements in the proximal sections of the GI tract (Mönnikes et al., 2001[ 77 ]). A delay in stomach emptying is likely accomplished through CRH-2 receptors, while type 1 receptors affect the colon (Mönnikes et al., 2001[ 77 ]). The effects produced by CRH are so prominent that CRH is now considered an ideal candidate for the treatment of irritable bowel syndrome (Martinez and Taché, 2006[ 69 ]). When serotonin is released in response to stress (Chaouloff, 2000[ 14 ]), it leads to an increase in the motility of the colon by stimulating 5HT-3 receptors (Mönnikes et al., 2001[ 77 ]). Moreover, it has also been suggested that stress, especially mental and emotional types of stress, increase visceral sensitivity and activate mucosal mast cells (Mönnikes et al., 2001[ 77 ]). Stimulation of the CNS by stress has a direct effect on GI-specific nervous system ( i.e. , the myenteric system or plexus) and causes the above mentioned changes in the movements of the GI tract (Bhatia and Tandon, 2005[ 5 ]). In fact, stress has a direct effect on the brain-bowel axis (Konturek et al., 2011[ 55 ]). Various clinical studies have suggested a direct effect of stress on irritable bowel syndrome, intestinal inflammation, and peptic ulcers (Konturek et al., 2011[ 55 ]).

In conclusion, the effects of stress on the GI system can be classified into six different actions: GI tract movement disorders, increased visceral irritability, altered rate and extent of various GI secretions, modified permeability of the intestinal barrier, negative effects on blood flow to the GI tract, and increased intestinal bacteria counts (Konturek et al., 2011[ 55 ]).

Stress and the Endocrine System

There is a broad and mutual relationship between stress and the endocrine system. On one hand, stress has many subtle and complex effects on the activity of the endocrine system (Sapolsky, 2002[ 97 ]; Charmandari et al., 2005[ 15 ]), while on the other hand, the endocrine system has many effects on the response to stress (Ulrich-Lai and Herman, 2009[ 117 ]; Selye, 1956[ 110 ]). Stress can either activate, or change the activity of, many endocrine processes associated with the hypothalamus, pituitary and adrenal glands, the adrenergic system, gonads, thyroid, and the pancreas (Tilbrook et al., 2000[ 116 ]; Brown-Grant et al., 1954[ 11 ]; Thierry et al., 1968[ 115 ]; Lupien and McEwen, 1997[ 64 ]). In fact, it has been suggested that it is impossible to separate the response to stress from the functions of the endocrine system. This premise has been advanced due to the fact that even a minimal amount of stress can activate the hypothalamic-pituitary-adrenal axis, which itself is intricately involved with the activation of several different hormone secreting systems (Sapolsky, 2002[ 97 ]). In different locations throughout this article, we have already discussed the effects of stress on hormones and various endocrine factors and, thus, they will not be further addressed.

Altogether, stress may induce both beneficial and harmful effects. The beneficial effects of stress involve preserving homeostasis of cells/species, which leads to continued survival. However, in many cases, the harmful effects of stress may receive more attention or recognition by an individual due to their role in various pathological conditions and diseases. As has been discussed in this review, various factors, for example, hormones, neuroendocrine mediators, peptides, and neurotransmitters are involved in the body's response to stress. Many disorders originate from stress, especially if the stress is severe and prolonged. The medical community needs to have a greater appreciation for the significant role that stress may play in various diseases and then treat the patient accordingly using both pharmacological (medications and/or nutraceuticals) and non-pharmacological (change in lifestyle, daily exercise, healthy nutrition, and stress reduction programs) therapeutic interventions. Important for the physician providing treatment for stress is the fact that all individuals vary in their response to stress, so a particular treatment strategy or intervention appropriate for one patient may not be suitable or optimal for a different patient.

Yunes Panahi and Amirhossein Sahebkar (Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, P.O. Box: 91779-48564, Iran; Tel: 985118002288, Fax: 985118002287, E-mail: [email protected], [email protected]) contributed equally as corresponding authors.

Conflict of interest

The authors declare that have no conflict of interest in this study.

Acknowledgement

The authors would like to thank the "Neurosciences Research Center of Baqiyatallah University of Medical Sciences" and the “Clinical Research Development Center of Baqiyatallah (a.s.) Hospital” for providing technical supports.

Stress: The Killer Disease

Stress and inflammation leave us vulnerable to depression..

Posted November 26, 2012

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Stress Kills. We’ve heard it before. It’s common sense. But how does stress kill? As a physician, I tend to imagine stress leading to high blood pressure and heart attacks and anxiety or depression . But how could stress, alone, do all that? Sure, there are stress hormones that get out of whack and cause chronic activation and damage in our brains and vasculature, but how do they do that? How does stress kill?

Lifetime exposure to chronic psychological stress is associated with elevated inflammation in the Heart and Soul Study .

I like the Heart and Soul Study . They are on my wavelength. The methods are solid. All the subjects have a history of some sort of cardiovascular disease, which is important (and they are mostly male, derived mostly from patients at the Veteran’s Association, so keep that in mind). And here they have looked into people's history of psychologic stress, measured their inflammatory cytokines, and hypothesize a connection. Inflammatory cytokines are chemicals released by the immune system activating armies of cells to attack invaders such as viruses, pathogenic bacteria, or cancer. The problem is that our immune system can be over-activated and lead to autoimmune disease. Most modern chronic disease, including atherosclerosis and depressive disorders are associated with elevations in these cytokines, elevations in autoimmunity, and diseases that linger and are difficult to eradicate and treat. The connection is confirmed by many other studies linking a history of trauma (all sorts) to elevations in cytokines.

The down-low is that stress is linked to bad cytokines (IL-6, TNF alpha, C reactive protein, etc.) and that stress is linked to PTSD and Major Depressive Disorder and anxiety disorders which are also linked to the bad cytokines… as is cardiovascular disease, even in psychologically healthy individuals. In addition, there are harmful behaviors which increase the inflammatory cytokines ( substance abuse , smoking ), and ameliorating behaviors that decrease them (exercise, meditation , sleep) less likely to be adhered to by those who have undergone inordinate psychological stress.

Where the rubber meets the road is that higher lifetime trauma was associated with higher levels of inflammatory cytokines at baseline and 5 years later. When the researchers controlled for psychological symptoms of the trauma (for example, PTSD or a clinical depression ), the relationship held, meaning those who had undergone trauma had elevations of inflammation even if their behavior and coping seemed more normal by psychiatric diagnostic standards. In these folks with pre-existing cardiovascular disease, higher inflammation is associated with greater risk of death and complication.

Can you avoid trauma? Not always. But through a healthy lifestyle, good wholesome nutrition , and stress reduction, you can sometimes ameliorate the long term damage. Researchers are beginning to measure the effects of these interventions in the body, using cytokine levels. The secret of how stress kills will not be a secret for too much longer.

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Copyright Emily Deans, MD

Emily Deans, M.D. , is a psychiatrist with a practice in Massachusetts.

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Stress: The Portrait of a killer Essay

The scientific documentary stress: portrait of a killer by Sapolsky and the genius Stanford University neurobiologist, MacArthur makes an all important finding that the body reacts spontaneously to stress. When one is stressed, the body shuts down all important systems, which include the immune system, and prevents any attempts of the body to repair cells. Moreover, stress results in increased hormone flow that may damage blood vessels, increase plaque in the blood arteries, resulting in blood pressure and resistance to blood flow. The research brings out the serious ramifications brought about by stress. Stress may lead to damaged brain cells, mostly affecting the hippocampus, and important brain sections responsible for learning and memory. This means stress badly affects ones emery and impairs their learning abilities. Moreover, the study while studying baboons that were found to react much the same with hums in stressful situations revealed that stress is directly related to social hierarchy. In other words, hierarchy as a social construct determiners the level of stress in an individual. The position of an individual in a hierarchy has a relation to the risk of diseases and the length of life of such individual. However, high levels of stresses as the documentary narrates are essential incases where on has to save their lives from predators. All the same, individuals currently cannot turn such stressing hormones offer, implying they have to continue fighting with corrosive hormones triggered by stressing situations. This is what has led to numerous cardiovascular related diseases, and reduced life span of individuals.

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Sapolsky in the documentary features various studies that have been carried out over the time to support his findings; which bring about many similarities between such studies and his research findings. One of the studies by Blackburn et al (573) explains that clinical psychological stress is major factor in many ageing diseases. Stress appraisal determines the type and degree for biological stress appraisals, and responses which according to the study are the psychological mechanisms that link diseases of aging and the biological stresses. In the study, chronically stressed female care givers and non-care giving group as a control group were exposed to an acute laboratory stressor, and their anticipatory challenge and threat appraisal measured. The caregivers portrayed an indirect difference in the telomere length, which is the measure of aging through anticipatory threat appraisals. This means such anticipatory appraisals contribute to a mechanism of psychological stress effects on aging of cells. These findings are in line with Sapolsky‘s findings that stress levels may prevent the body from repairing itself, which leads to faster aging.

Moreover, the documentary utilizes the detailed work of Marmot, a renowned epidemiologist. Marmot carried out major research studies on stress levels among Britain civil servants. In this study, Marmot revealed that the lower the status of a civil servant the higher the risk of cardiovascular diseases. This as Marmot explains may be as a result of metabolic syndrome related to lipid disturbance, which result from insulin resistance. Much of the risk is mediated by metabolic syndrome and plasma fibrinogen. Moreover, low control of an employee as Marmot found out was responsible for increased stress levels in civil servants (Rivett, 2007). Individuals at lower ranks in the job structure may not have any control of their activities, but depend on their superiors on the hierarchy to disseminated orders that have to be followed. The lack of control in making decisions according to Marmot is therefore responsible for increased stress levels, and the respective heart diseases. Sapolsky uses these findings in supporting his argument that baboons on the lower social hierarchy proved to have high stress levels, and lived much less compared to those on the higher social hierarchy. This may be explained by the fact that baboons in a higher hierarchy are at much lower risk of predation due to their control compared to the weaker baboons at the lower ranks, whose fears and subordination increases stress levels.

Sapolsky highlights the research by Dr. Carol Shivey of Wake University. Shivey in a research study revealed that the cardiovascular system in humans is negatively affected by stress, which leads it to increased cases of atherosclerosis. This increases the heart attack rates in individuals. Shivey further expounds that stressed individuals will tend to concentrate fat deposits around their abdominal area, which is major health risk. Shivel relates increased stresses and fat accumulation to the increasing obesity cases globally, which is a global epidemic. Shively in the film also articulates the role of pleasure in stress reduction. Dopamine is a hormone whose concentration in the blood is affected by stress levels, with less stressed people portraying more dopamine compared to the more stressed people. In other words, a brain scanning image portrayed subordinate monkeys to have a dull brain, while the dominant ones had much lighter brains. The dull brain portrays increased stress levels. Sapolsky also uses the study by Rosseboom regarding the 1944 Dutch Hunger. Rosseboom in a study of the effects of famine stress on fetal development in women who survived the famine remarks that the damage caused by the famine is still there more than 60 years after. Therefore, stress experienced by such individuals at their fetal stage affected the people, with many of them today being at higher risk of heart diseases, higher cholesterol levels, among other cardiovascular diseases. Stress hormones from their mother’s blood Rosseboom indicates affected such fetal nervous system as they tried to survive the starvation. Consequently, prolonged stress build up results in serious effects not only to an individual, but to their children particularly in pregnant mothers.

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Sapolsky in the documentary highlights the tragedy in Maasai Mara in Kenya, where dominant and aggressive baboons contacted TB believed to be from food left by tourists. The epidemic swept away the entire dominant male class, and resulted to a major change in the baboons’ troop. As the dominant baboons with much less stress levels were wiped out, they left the subordinates with higher stress levels to take charge of the troop. Therefore, the high stress levels among the baboons at the lower hierarchy gradually reduced, resulting in a decreased in stress related diseases among the troop. This was because, the group’s hierarchy was greatly weakened to become less hierarchical; there was much less fear and threats among the remaining baboons. Sharing and grooming was a new trend that resulted in reduced stress cases, and more healthy baboons. Therefore, culture has a huge impact on individual’s stress levels.

Sapolsky in the documentary offers various ways in which individuals may reduce stresses and prevent such life threatening diseases caused by increased stressful conditions. Body relaxing activities such as Yoga are a great way in which individuals may reduce stresses as a self-care mechanism. Moreover facials, massages and other body care services help the body to relax and facilitate smooth flow of blood. Other stress minimizing activities include fun and healthy social interactions with peers, deep breathing when faced with a stressful situation, taking stroll in nature, and reading for fun. Having increased self-control helps in reducing stress levels; one is able to make decisions and affect them, rather than depend on commands and orders. This as Marmot explains in the documentary facilitates both learning and enhanced memory abilities. Any activity that triggers a relaxation response would be essential in reducing stress in humans. Such attributes as self-confidence, being actively involved in productive and fan activities, or doing anything that one enjoys are also methods that can be used to reduce stress in humans. In order to implement such stress reducing activities, sensitization through various media, and public health based meetings may help in passing the message to the community. Such stress reduction and control methods should also be introduced in all Schools at all levels of study, to create a well-informed population from the basic levels of education.

The film was very helpful and an eye opener in our daily activities. The documentary deals particularly with our daily activities, and how these activities define and impact on us. For example, in the work place, the film is of critical importance in etching individual how they can cope with the stressful conditions imposed by their hierarchy levels. Since stressing precursors may not be done away with completely, the film prepares individuals on how best to react in case one is exposed to such stresses. Moreover, through the film, it clear that having a good level of confidence, self-control and autonomy to do what one finds joy in may be a great way to alleviating stressful conditions. People have also to establish and nurture healthy social interactions and mutual sharing where they can mediate on problems of one another. As the film portrays, effective social groups and interaction help in sharing the stress burden in many people, especially for those in subordinate levels. Being involved in extensive much exercises, reading for fun, and taking a stroll in nature as the film indicates are simple activities that may be embraced to result in healthy life away from stresses as they stimulate the mind and lead to relaxation. The film findings are in agreement with many research studies on social interactions and stress reduction. However, the film raises the question whether the patterns observed in baboons and other non-human primates have the same ramifications on humans. This means though Saposlky heavily utilizes biologists and neurologists findings to support his ideas, there should be detailed research studies that tie the findings of studies carried out on non-human primates with research studies on humans, to have a better understanding of the actual effects of stress on humans.

• Blackburn E.H., et al. Stress appraisals and cellular aging: a key role for anticipatory threat in the relationship between psychological stress and telomere length, Brain Behavior Immunology, 26.4(2012), 573-579.
• Rivett Geoffrey, Professor Sir Michael Marmot, Department of Epidemiology and Public Health, National Health Service History, 2007 http://www.nhshistory.net/cvmarmot.html Sapolsky M. Robert. Dir. Stress – Portrait of a Killer, National Geographic 2008, Film

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Stress And Heart Health: Managing The Silent Killer

The key to preserving our hearts’ well-being is akin to finding the ultimate treasure in this narrative—a heart of gold. Effective stress management holds the map, and Dr. Elizabeth A. Stanley’s groundbreaking research at Georgetown University serves as the guide. It reveals that mindfulness training can act as a soothing balm, reducing stress levels and improving markers of heart health, all while helping us navigate through life.

A study called ‘The Framingham Heart Study, ongoing since 1948, emphasizes that social support and positive relationships act as shields against stress’s effect on the heart. Strong social connections lower the risk of heart disease, highlighting the importance of nurturing healthy  relationships. Moreover, the power of regular physical activity cannot be undermined. A study in  “Psychosomatic Medicine”  shows that routine exercise reduces stress-related  cardiovascular responses. Exercise not only eases stress but also boosts circulation and reduces inflammation, promoting overall heart health.

Drawing insights from these studies, it’s evident that mindfulness, nurturing our relationships, and consistent physical activity play vital roles in bolstering our heart health. Addressing stress is more than just enhancing our well-being. Prioritizing stress management isn’t just about well-being—it’s a critical step in safeguarding our hearts.

This article has been authored by Prof. Moulika Mandal, Faculty of Psychology, FLAME University.

(Source:- https://womenshine.in/stress-and-heart-health-managing-the-silent-killer-by-flame-university/ )

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Business of Well-being

Workplace stress: a silent killer of employee health and productivity.

"Having a job in many ways improves an individual's health and overall attitude toward life." However, many people face significant stress in the workplace that it outweighs any possible benefits and even poses a threat to their health. ‍

The United States' National Institute for Occupational Safety and Health defines job stress as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker. Job stress can, in turn, lead to poor health and even injury. ‍

Many workers report experiencing work-related stress at their jobs and this compromises their performance and health. A recent survey by Northwestern National Life revealed that about 40% of workers reported that their jobs were extremely stressful. In another survey by Yale University, 29% of workers reported feeling extreme stress because of their jobs. ‍

Stress levels vary between professions and population groups. Some workers are at a higher risk of stress than others. Studies reveal that younger workers, women, and those in lower-skilled jobs are at most risk of experiencing work-related stress and its attendant complications.

Casual full-time workers, who are likely to have the lowest job control and high job demands are most at risk of job strain.

The Impacts of Workplace Stress

Workplace stressors are classified as physical and psychosocial. Physical stressors include noise, poor lighting, poor office or work layout, and ergonomic factors, such as bad working postures.

Psychosocial stressors are, arguably, the most predominant stress factors. These include high job demands, inflexible working hours, poor job control, poor work design and structure, bullying, harassments, and job insecurity.

Workplace stress not only affects the worker, it also has adverse effects on company performance well. The effects of job-related strain are evident in workers' physical health, mental health, and their behavior.

These effects occur in a continuum, beginning as distress in response to stressors. Distress, in turn, leads to elevated blood pressure and anxiety, which increase the risk of coronary heart disease, substance abuse, and anxiety disorders. ‍

The impact of stress on cardiovascular disease has been well established: Studies have shown that workplace stress is a strong risk factor for preludes to cardiovascular disease (obesity, high blood cholesterol, high blood pressure) and of adverse cardiovascular events, such as heart attack and stroke. ‍

There is also a growing body of evidence that work-related stress increases one's risk of diabetes. Other physical health problems linked to workplace stress include immune deficiency disorders, musculoskeletal disorders including chronic back pain, and gastrointestinal disorders, such as irritable bowel syndrome. ‍

Workplace stress also has adverse effects on workers' mental health, with an increased risk of anxiety, burnout, depression, and substance use disorders. Workers who are stressed at work are more likely to engage in unhealthy behaviors, such as cigarette smoking, alcohol and drug abuse, and poor dietary patterns. ‍

With these attendant health effects, workplace stress reduces employee productivity, increases absenteeism and presenteeism, increases the number of days taken off work for doctor visits, and increases healthcare costs incurred by employers. Workplace stress is also linked to higher accident and injury rates and higher turnover rates, both of which increase administrative costs. ‍

Workplace Interventions for Reducing Stress

Workplace stress is preventable and identifying the potential sources of stress to employees in an organization is the first step in addressing them. Effective interventions for reducing workplace stress can be classified as primary, secondary, and tertiary. ‍

Primary interventions involve proactive measures to prevent stress by removing or reducing potential stressors. This level of intervention focuses on the sources of physical and psychosocial stress in the workplace. Examples of primary interventions include: ‍

• Redesigning the work environment ‍ ‍
• Providing breaks and nap-times for employees ‍ ‍
• Increasing employee participation in decision making and work planning ‍
• Increasing time and resources for completing specific job tasks ‍
• Matching job description with employee skills and qualifications ‍
• Creating clear promotion and reward pathways ‍
• Eliminating physical hazards ‍
• Substituting with safer equipment and technology ‍
• Establishing control measures to reduce worker's exposure to occupational hazards ‍
• Promoting the use of personal protective equipment ‍

Secondary interventions are corrective and are focused on altering the ways workers perceive and respond to stressors. These interventions aim at improving worker's ability to cope with stress and detect stress-induced symptoms early. Examples of secondary interventions include: ‍

• Training and education of employees ‍
• Cognitive behavioral therapy training for workers ‍
• Routine health surveillance - screening for high blood pressure and stress symptoms ‍

Tertiary interventions are forms of control at the level of the illness. These are initiated for workers who are already experiencing stress. Tertiary interventions involve providing treatment, compensation plans, rehabilitation programs, and return to work programs for affected workers. Tertiary interventions include: ‍

• Providing medical care and employee assistance programs to affected workers ‍
• Return-to-work plans including modification and redesign of work ‍

Workplace stress is a silent, and oft-neglected, factor which impairs employee health and productivity. It not only affects the workers but also contributes significantly to a decline in a company's overall success. Employers should begin to tackle this worrisome concern to create a healthier, safer, and more productive work atmosphere."

Changing the Narrative in Corporate Wellness, an Interview with CCWS Graduate, Renee Fortuna

Human connection is key to a thriving workplace - interview with shelly bell, well-being means different things to everyone - says jessica domann, well-being programs are not a one-size-fits-all solution - csilla lorincz, ccws graduate, rethinking corporate wellness program design - interview with yolanda menegazzo, featured reading, medical travel growth in south korea and strategies for the future, global healthcare accreditation (gha) launches gha for business and issues organizational resiliency guidelines amidst omicron and emerging variants, “they dumped us like trash:” creating the worst corporate culture like better.com.

Loneliness: the silent killer

Researchers from numerous disciplines have begun to investigate the heavy toll that loneliness takes on society.

They call it the silent killer, because its effects are not immediately visible and the condition is rarely discussed. Yet almost everyone has suffered from it at one time or another. It destroys people slowly but steadily. The silent killer is loneliness.

Although the idea that loneliness can cause emotional distress is not new, it is only within the last decade or so that researchers have begun to gain a true sense of the physical impact of loneliness and develop insights into its biological underpinnings. The conclusions of this work are startling.

In 2015, psychology professor Julianne Holt-Lunstad of Brigham Young University led a meta-analysis of 70 papers involving more than 3.4 million participants followed over an average of seven years. The study found that a lack of social connections was as great a risk factor for early death as smoking 15 cigarettes a day, and that it constitutes a greater risk than such lifestyle risk factors as obesity and lack of exercise. Other recent studies have connected loneliness and social isolation with a range of health problems, including heart attacks, strokes, drug abuse, alcoholism, anxiety and depression.

And just how widespread is this affliction? According to a 2014 report by Canada’s National Seniors Council, about half of people over the age of 80 report feeling lonely. This emotion is not limited to the elderly. A 2016 survey  (PDF) by the American College Health Association of a Canadian cohort of 44,000 postsecondary students revealed that two-thirds of them reported feeling “very lonely” at some point in the previous 12 months. An online U.S. survey of 20,000 adults conducted in 2018 by the health insurer Cigna revealed that 40 percent of Americans said they lacked a meaningful relationship and felt isolated from others. A 2018 survey of 55,000 British citizens conducted for the BBC found that a third of respondents often feel lonely.

The view that loneliness is a public health issue deserving of public funds and national attention is being championed most strongly in the United Kingdom. In January 2018, the British government took the unusual step of appointing a Minister for Loneliness in a bid to call attention to “the forgotten millions who live amongst us ignored, to our national shame.” Although the title may sound fanciful, it is part of a multimillion-dollar strategy aimed at reducing visits to the emergency room and the doctor’s office that result from loneliness. Doctors are now being encouraged to treat loneliness by “prescribing” activities like cooking classes, walking clubs and art groups, and are starting to hire “social prescribing experts” – akin to community guides – based in their offices.

Social prescribing is also being tested in Ontario at 11 facilities in a pilot project launched by the Alliance for Healthier Communities, running from September 2018 to December 2019. Doctors refer patients to a “link worker” who connects them with community services and programs that match their needs. The alliance suggests the “prescription” can take many forms: dance lessons, karaoke, museum visits, even bingo.

Many applaud this approach. “It’s a tremendous service to society to bring the subject out of the closet like this,” says Ami Rokach, a clinical psychologist and contract faculty member at York University. Dr. Rokach recalls that when he began researching loneliness in the 1980s, his colleagues felt it was unworthy of serious study. “They couldn’t understand my interest. They wanted to know if I had personal issues with it.”

That attitude has changed and today loneliness has become a focus of interest for researchers from various disciplines, including sociology, neuroscience, psychology and gerontology. Even so, the topic still carries a heavy burden of shame.

“There is a stigma attached to being lonely. People would rather admit to being schizophrenic than admit to suffering from loneliness,” notes Dr. Rokach. “In almost 40 years of counselling I’ve only had one patient – just one – come in because they said they were lonely.” Dr. Rokach believes this stigma derives from the notion that there is some personal failure connected with being lonely. “The lonely person tells himself, ‘I don’t have anyone because I’m a loser.’”

In her 2016 book, The Lonely City: Adventures in the Art of Being Alone , British author Olivia Laing echoes his observation: “Loneliness feels like such a shameful experience, so counter to the lives we are supposed to lead, that it becomes increasingly inadmissible, a taboo state whose confession seems destined to cause others to turn and flee.”

Scientists contend that loneliness isn’t a personality defect or a sign of weakness, but rather a survival mechanism like hunger or thirst, driving us toward the benefits of human companionship. In his influential 2008 book, Loneliness: Human Nature and the Need for Social Connection the late University of Chicago psychologist John Cacioppo argues that loneliness is a reflex honed by natural selection. Since early humans would have been at a disadvantage if isolated from a group, it makes sense for loneliness to stir a desire for company.

However, psychologists stress that loneliness should not be confused with solitude. Loneliness stems from a perceived isolation, the sense that a person’s relationships do not meet their social needs. In contrast, “People choose solitude not because they are lonely, but because they can only do certain things when they are alone,” explains Dr. Rokach. “We tend to associate loneliness with geographic isolation. But someone can be surrounded by people on a city bus or at a concert and still feel disconnected from others.”

Even people in long-term relationships can feel lonely. A 2012 study by researchers at the University of California, San Francisco found that, among nearly 700 Americans over age 60 who described themselves as lonely, 63 percent were married. “That is the most painful loneliness of all, relationships where there is no emotional intimacy,” says Dr. Rokach.

According to the late Dr. Cacioppo, chronic loneliness sets in motion processes that cause damage at the cellular level. Blood pressure rises, cognition dulls and immune systems are ravaged. The aging process accelerates under the corrosive effect of stress hormones, while arteries tighten and raise the risk of heart disease. The lonely sleep poorly, report more daytime fatigue and experience memory problems.

Despite the alarming number of people affected by loneliness, there aren’t many reliable ways to diagnose, prevent or treat it. This is partly because assessing loneliness is not as simple as measuring blood pressure or taking an X-ray.

Enrico DiTommaso, a psychology professor at the University of New Brunswick, invented a scale to assess loneliness that has been translated into several languages and is used around the world. The scale is composed of 15 questions, a total that Dr. DiTommaso gradually whittled down from a starting point of 76. Participants are asked to rate their answers using a seven-point system ranging from “strongly agrees” to “strongly disagrees.” Sample questions include: “In the last year I felt a part of a group of friends” and “In the last year I felt close to my family.” The scale allows a person to assess how lonely they are, along with what type of loneliness they may be experiencing at a given moment, but not necessarily why.

The question of why some are more susceptible to loneliness than others is open to conjecture. Andrew Wister, director of the Gerontology Research Centre at Simon Fraser University, says that loneliness is a difficult subject to study because of its complexity, which may explain why far more Canadian researchers today are investigating social isolation, especially among the elderly, rather than tackling the concept of loneliness head-on.

Not only are there many types of loneliness, the causes vary for different groups, says Dr. Wister. With older adults, the triggers are more likely to be related to poverty, or the marginalization that can occur from being a member of the LGBTQ community or other minority group. Loneliness in seniors can also be related to physical challenges such a loss of mobility and cognitive impairment.

For young people, meanwhile, “loneliness is often a product of the failed expectations of relationships,” says Dr. Wister. Facebook could be partly to blame, especially if people substitute online connections for actual relationships, he says. As well, Facebook can create the illusion that one has a large number of friends when in truth many of these relationships are quite superficial. The social media platform may also induce a sense of failure when your friends’ postings suggest that they are living much more interesting and exciting lives than you are.

Frances Chen, a UBC psychology professor who has been studying the impact of loneliness on first-year university students, notes that online relationships can’t establish the same feeling of trust and rapport that one can get in face-to-face encounters. “In conversation, so much is communicated non-verbally by expressions and body language and what our other senses pick up. So many signals are passed between people. Even scents can have a powerful effect,” she says.

Insecurities about social acceptance is a huge issue for students, adds Dr. Chen, who notes that when students are asked to compare how many close friends they have made in comparison with how many they believe other students have made, most claim they are not faring as well. She finds that interesting because it runs counter to the common psychological tendency of people to rate themselves above average when asked questions such as “How good looking are you?” or “How good a leader are you?”

David McConnell, a researcher at the University of Alberta’s faculty of rehabilitation medicine, feels that the incidence of loneliness and social isolation in Canada has increased in recent years due to an ebb in “social capital,” a term that refers to the networks of relationships among people that enable society to function effectively. The concept was popularized by Harvard University political scientist Robert Putnam in his 2000 nonfiction book, Bowling Alone .

“People today are less likely to trust their neighbours for support, fewer people are involved in volunteering, and there is a dramatic decline in church membership,” says Dr. McConnell. “We’re not as plugged-in locally.”

Dr. McConnell says an insidious aspect of loneliness is that the stress it brings “undermines our ability to self-regulate our emotional responses.” Not only are lonely people more likely to be volatile, they also often display distorted thinking about others’ intentions and view themselves as victims in their failed attempts to make connections. In other words, loneliness can create its own self-defeating behaviour.

Interestingly, the concept of loneliness as a social pain has been demonstrated by functional magnetic resonance imaging, or fMRI . The emotional region of the brain activated when a person experiences rejection is the same area that registers emotional responses to physical pain.

But while researchers now have a fuller understanding of the biological threats posed by loneliness, the answer of how to solve persistent loneliness remains elusive. In December 2009, Dr. Cacioppo and two co-authors published a sweeping analysis of every study on loneliness intervention done from 1970 to September 2009. Treatments fell into four categories: fostering “social contact” by bringing lonely people together or providing access to email; offering “social support” from visitors, companion dogs or group activities; teaching social skills; and changing the way they think about themselves and others. Of those, only the last, training in “social cognition” – the ability to understand and navigate social interactions – yielded promising results.

In the final analysis, lonely people need to recognize loneliness for what it is – a trap – and make a conscious decision to break the negative cycle of thinking that tells them to play it safe by staying isolated. Ironically, in order to establish meaningful connections with others, it seems that the chronically lonely first have to establish a new connection with themselves.

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You had me till your last paragraph. Talk about blaming the fallout of societal behaviour that excludes many people even young seniors and all ages of differently abled people, on the survivor!

SO wrong. Sure activities are great but when those around you turn a cold shoulder to you because you don’t identify to THEM as a someone like them, you’re hooped and isolated via the willful exclusion of others who’ve been there longer or have some kind of other power over the “social” group. Been there … done that.

Much of social connection is the luck of economics and timing. Neither is anyone’s “deficit” to pull their socks up over. Since they don’t even have “socks” to pull up in most cases.

Attitudes of those who inherited or were in the right place for their hard work to net them permanent social connections should stop acting like doing what they did or think we should do will work for everyone. It is a lousy obvious, way of pushing back from changing the things they can do help us.

INCLUSION and DIVERSITY are the only way out of this.

@Page Turner I’ve never read a comment dripping with such a sense of entitlement! And you managed to shoehorn in inclusiveness, diversity, victim-blaming, white guilt etc in a discussion about loneliness. Good stuff 🙂

Regarding the last sentence “it seems that the chronically lonely first have to establish a new connection with themselves” – this is very true. A very recent (2019) randomized study published in PNAS demonstrated that the ancient practice of mindfulness reduces loneliness and increases social contact. Here’s the reference:

Lindsay, et al. (2019). Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial. Proceedings of the National Academy of Sciences, 201813588.

the survey is the most abused research tool in any field.

Leftist drivel. There is nothing wrong with choosing to be alone.

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High blood pressure: The silent killer

By Mayo Clinic Health System staff

One of the most dangerous health conditions is also one of the sneakiest.

High blood pressure is often called the "silent killer" because most people who have it don't have any symptoms. And that silence can be deadly. High blood pressure can lead to a host of serious problems, including heart attack , heart failure and stroke . That's why it's important to know your risk factors for developing high blood pressure — and to take steps to lower your risks.

Risks you can change

Big risk factors are being overweight, too much salt (sodium) in your diet, smoking and not getting enough exercise. Being overweight strains your heart. Exercise strengthens it.

Aim for 150 minutes of physical activity a week. Exercise will help you build your heart muscle and may also help you lose weight.

Too much salt can cause you to retain fluid, which increases blood pressure. Salt hides in all processed foods, like hot dogs, lunch meats, pickles and all canned foods. It's better to eat fresh or frozen vegetables. Salt also is in all cheese. Download an infographic about salt.

If you smoke or use chewing tobacco, it's time to quit.

Tobacco temporarily raises blood pressure in the short term, and can damage artery walls over time. Breaking the habit is one of the best things you can do for your health.

Several effective medications are available to help people quit the habit.

Stress may also play a role in developing the condition, either by temporarily increasing your blood pressure or by leading you toward unhealthy coping strategies, such as smoking or drinking too much alcohol.

And those you can't

Unless you can turn back time, your risk of developing blood pressure is going up. That's because risk increases as you age.

High blood pressure tends to run in families, so if one of your parents or a sibling has the condition you're more likely to as well. And your race may also increase your risk. High blood pressure is more common — and often more severe — among African-Americans.

Why it matters

High blood pressure can cause significant damage to your heart, eyes, kidneys, brain and blood vessels. Left untreated, this can lead to kidney failure or vision loss.

Your ability to think, remember and learn can also be affected by high blood pressure. There's even a type of dementia — vascular dementia — caused by high blood pressure.

What you can do

Know your numbers — and act on them.

People 40 and older, or anyone younger with risk factors, should have their blood pressure checked by a provider once a year. Younger people without risk factors should be checked at least every two years.

If your blood pressure is high, talk to your provider your provider will recommend lifestyle changes or medication to lower it.

Blood pressure should be 120/80 or lower. If it's consistently higher, lifestyle changes or medication, or a combination of the two, can usually bring it down to a healthy level.

Learn more about blood pressure:

• Visit our Classes & Events page to find a blood pressure screening near you.
• Get the facts. Download an infographic about high blood pressure .

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Stress: the silent killer.

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So, but how people reduce the stress? People use different ways to reduce their stress. Some of them use unhealthy ways of coping with stress, for example, smoking, drinking too much, sleeping too much, using pills or drugs to relax, withdrawing from friends, family and activities. This entire thing is not good way to protect our mind and body of stress. People should connect with others. Spend time with positive people who enhance their life. A strong support system will buffer person from the negative effects of stress. People who have stress they need to do something what they really enjoy every day. For example, make time for leisure activities that bring joy - maybe it is some sport activities or some cultural events. To sum up, people should try to protect themselves of stress situation, but if some life situations bring stress to us, we need to fight with it and try to eliminate stress. If people don’t fight with stress it can bring big problems with physically and mental problems, for example, depression, which is very big mental problem nowadays. People should think about their body and their mental health, because this is very important for us in future. We need to love ourselves, our body and our brain. …

Everyone person has stress in their life. It is not important what age, status, orientation have person, is she is businesswoman or housewife, and anyway in this people life was or will be some stress situation. There are a variety of stresses. The stress can be positive or devastating. Tension or stress is a result of some changes in people life, anger and health problem – all this things can very strongly activate the physiological and mental processes in the human body. If person have stress he can has different kind of stress symptoms, for example, heartburn, stomach pain, nausea, problems in communication, neck ache, back pain, muscle spasms e.t.c.

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• Risk Factors
• Managing High Blood Pressure
• High Blood Pressure Facts
• Measure Your Blood Pressure
• Hypertension Management Program (HMP) Toolkit
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• Rapid Evaluations of Telehealth Strategies to Address Hypertension
• Team-Based Care to Improve Blood Pressure Control
• High Blood Pressure Maps and Data Resources
• The Surgeon General's Call to Action to Control Hypertension
• Federal Hypertension Control Leadership Council (The Council)
• About Heart Disease

About High Blood Pressure

• About Stroke
• About Cholesterol
• High blood pressure, also called hypertension, is blood pressure that is higher than normal.
• High blood pressure usually has no warning signs or symptoms.
• High blood pressure usually develops over time.

Definition of blood pressure

Blood pressure is the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body.

What are normal blood pressure numbers?

A normal blood pressure level is less than 120/80 mmHg. 1

No matter your age, you can take steps each day to keep your blood pressure in a healthy range .

What is high blood pressure (hypertension)?

High blood pressure, also called hypertension, is blood pressure that is higher than normal. Your blood pressure changes throughout the day based on your activities. Having blood pressure consistently above normal may result in a diagnosis of high blood pressure (or hypertension).

The higher your blood pressure levels, the more risk you have for other health problems, such as heart disease , heart attack , and stroke .

Your health care team can diagnose high blood pressure. They can also make treatment decisions by reviewing your systolic (first number) and diastolic (second number) blood pressure levels and comparing them to guidelines.

The guidelines used to diagnose high blood pressure may differ from one health care provider to another:

• Some health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 140/90 mm Hg or higher. 2 This limit is based on a guideline released in 2003, as seen in the table below.
• Other health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 130/80 mm Hg or higher. 1 This limit is based on a guideline released in 2017, as seen in the table below.

Blood pressure levels according to The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (2003 Guideline) 2

systolic: less than 120 mm Hg diastolic: less than 80 mm Hg

At risk (prehypertension)

systolic: 120–139 mm Hg diastolic: 80–89 mm Hg

High blood pressure (hypertension)

systolic: 140 mm Hg or higher diastolic: 90 mm Hg or higher

Blood pressure levels according to The American College of Cardiology/American Heart Association Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults (2017 Guideline) 1

systolic: 120–129 mm Hg diastolic: less than 80 mm Hg

systolic: 130 mm Hg or higher diastolic: 80 mm Hg or higher

If you are diagnosed with high blood pressure, talk with your health care team about your blood pressure levels and how these levels affect your treatment plan.

Signs and symptoms

High blood pressure usually has no warning signs or symptoms, and many people do not know they have it. Measuring your blood pressure is the only way to know whether you have high blood pressure.

High blood pressure usually develops over time. It can happen because of unhealthy lifestyle choices, such as not getting enough regular physical activity. Certain health conditions , such as diabetes and having obesity, can also increase the risk for developing high blood pressure. High blood pressure can also happen during pregnancy .

Potential problems having high blood pressure could casue

High blood pressure can damage your health in many ways. It can seriously hurt important organs like your heart, brain, kidneys, and eyes.

The good news is that, in most cases, you can manage your blood pressure to lower your risk for serious health problems.

Heart attack and heart disease

High blood pressure can damage your arteries by making them less elastic. This decreases the flow of blood and oxygen to your heart and leads to heart disease . In addition, decreased blood flow to the heart can cause:

• Chest pain, also called angina.
• Heart attack , which happens when the blood supply to your heart is blocked and heart muscle begins to die without enough oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
• Heart failure , a condition that means your heart can't pump enough blood and oxygen to your other organs.

Stroke and brain problems

High blood pressure can cause the arteries that supply blood and oxygen to the brain to burst or be blocked, causing a stroke . Brain cells die during a stroke because they do not get enough oxygen. Stroke can cause serious disabilities in speech, movement, and other basic activities. A stroke can cause death.

Having high blood pressure, especially in midlife, is linked to having poorer cognitive function and dementia later in life. Learn more about the link between high blood pressure and dementia from the National Institutes of Health's Mind Your Risks ® campaign.

Kidney disease

Adults with diabetes, high blood pressure, or both have a higher risk of developing chronic kidney disease than those without these conditions.

Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes . Talk with your health care team about:

• Physical activity each week (about 30 minutes a day, 5 days a week)
• Not smoking
• Eating a healthy diet, including limiting sodium (salt) and alcohol
• Keeping a healthy weight
• Managing stress

Learn more about ways to manage and prevent high blood pressure.

In addition to making positive lifestyle changes, some people with high blood pressure need to take medicine to manage their blood pressure.

Talk with your health care team right away if:

• You think you have high blood pressure.
• If you've been told you have high blood pressure but do not have it under control.

By taking action to lower your blood pressure, you can help protect yourself against heart disease and stroke, also called cardiovascular disease (CVD).

• Whelton PK, Carey RM, Aronow, WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol . 2018;71(19):e127–e248.
• National High Blood Pressure Education Program. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [PDF – 223K] . National Heart, Lung, and Blood Institute; 2003.

High Blood Pressure

High blood pressure increases the risk for heart disease and stroke, two leading causes of death for Americans.

For Everyone

Health care providers, public health.