Stress, Heart Disease, Exercise & Death

Multiple prior clinical research studies have identified apatients reporting low levels of personal stress did
link between high levels of stress and the risk ofnot appear to experience any significant
death in patients with coronary artery disease (CAD).improvement in mortality risk whether they achieved
Aerobic exercise training is a standard component ofa high level of exercise capacity improvement or a
rehabilitation programs for patients with CAD. Alow level of exercise capacity improvement.
properly supervised exercise training program forThe results of this study suggest that (as has
patients with CAD, including patients who havepreviously been shown) a high level of personal
suffered a heart attack, has been shown to reducestress is independently associated with an increased
the risk of CAD-related death. At the same time, it isrisk of dying from preexisting CAD. A second finding
also well known that regular aerobic exercise can alsoof this study, which has also been confirmed by
help patients to better cope with high levels ofother studies, is that self-perceived levels of stress
personal stress, and also improves the symptoms ofcan be significantly reduced with regular aerobic
depression and other mental health disorders, as well.exercise. The most interesting and novel finding of
An intriguing clinical research study, newly published inthis study, however, is that exercising at a level that
the American Journal of Medicine, evaluated theincreases one's exercise capacity by at least 10
impact of exercise training on the risk of death inpercent appears to be a potentially powerful way of
patients with CAD. The two "experimental" groups ofreducing the increased mortality risk that is
patients included 53 patients with CAD who reportedassociated with chronically elevated levels of personal
high levels of stress in their lives, and 369 patientsstress in patients with CAD.
with CAD who reported low stress levels in theirOne potential limitation of this clinical study is that it is
personal lives. These two groups of patientsnot entirely clear how well the patients in each group
participated in a cardiac rehabilitation program thatwere matched in terms of the severity of their CAD
included formal aerobic exercise training. A "control"(as well as other chronic illnesses, including mental
group of 27 patients with CAD was also included inhealth and personality disorders). For example, at
this research study, and these control patients alsoleast some of the experimental group patients who
reported high levels of stress in their lives. However,were unable to improve their exercise capacity by at
unlike the experimental group patients, this controlleast 10 percent may have been unable to do so due
group of patients did not undergo cardiacto the presence of serious illnesses (including more
rehabilitation, or any other form of supervisedsevere heart disease) that limited their ability to
exercise training. The subsequent findings of thisexercise. In such cases, the increased risk of
clinical research study were rather dramatic.mortality observed in this study may have been
Overall, the risk of death among the patients withdirectly caused by the presence of more serious
CAD who reported high levels of stress was aillnesses in these patients, when compared to the
whopping 4 times greater than the mortality rate ofpatients who were able to more dramatically improve
the patients with low levels of stress in their lives (22their exercise capacity. However, as most of the
percent vs. 5 percent, respectively).findings of this clinical research study are consistent
As has been shown in previous clinical studies, regularwith larger and better controlled previous studies, it is
aerobic exercise appears to decrease self-reportedvery likely that there is some validity in its more
stress levels. In this study, the percentage ofnovel conclusions (and, most notably, that vigorous
patients reporting severe levels of stress declinedand regular aerobic exercise may directly reduce
from 10 percent, at the beginning of the study, to 4stress-related physiological factors that increase the
percent, by the end of the study, among patientsrisk of dying from CAD).
who underwent formal exercise training.Prior to embarking on a new or more vigorous
Perhaps the most interesting finding from this studyexercise program, I advise that you first be
was that patients who increased their total exerciseevaluated by your personal physician, especially if you
capacity by at least 10 percent also lowered their riskhave CAD or other serious illnesses. (For an in-depth
of death by a rather amazing 60 percent whenoverview of the benefits of exercise on cancer
compared to patients who achieved a less than 10prevention, look for the publication of my new book,
percent improvement in exercise capacity. Moreover,"A Cancer Prevention Guide for the Human Race," in
among the patients who reported high levels ofthe spring of 2010.)
stress in their lives, the risk of dying during theDisclaimer: As always, my advice to readers is to
course of this clinical study was dramatically reducedseek the advice of your physician before making any
in the group of patients who were able to increasesignificant changes in medications, diet, or level of
their prior exercise capacity by at least 10 percent. Inphysical activity
fact, while 19 percent of the "highly stressed"The information in this column is intended for
patients who achieved little or no improvement ininformational purposes only, and does not constitute
their exercise capacity died during the course of thismedical advice or recommendations by the author.
study, none of the "stressed" CAD patients whoPlease consult with your physician before making any
managed to increase their exercise capacity by atlifestyle or medication changes, or if you have any
least 10 percent died. On the other hand, CADother concerns regarding your health.