Being diagnosed with any serious medical condition is stressful. Learning you have pulmonary hypertension can be especially upsetting. The symptoms of fatigue and shortness of breath may get in the way of living your normal life, and it is natural to worry about serious complications occurring if the disease progresses.

Emotional stress can lessen the quality of life. That's reason enough to find every way you can to let off pressure. Can stress also exacerbate pulmonary hypertension?

It's well known that emotional stresses can affect overall blood pressure. In fact, chronic stress is a risk factor for common hypertension -- the condition that doctors measure by putting a cuff around the upper arm and inflating it. Emotional stress is now known to alter the balance of a variety of brain chemicals, including cortisol and adrenaline. These changes can also impair the ability of blood vessels to widen or constrict as needed.

The link between mental stress and pulmonary hypertension, or high blood pressure in the pulmonary arteries, isn't as clear as it is with general high blood pressure. But there is some evidence that being under stress may affect the level of strain on the heart. In research published in the journal Clinical Physiology, Swiss researchers investigated whether mental stress increases pulmonary artery pressure. The experimenters administered a standardized 10-minute mental stress test to seven patients. While taking the test, the pressure in their pulmonary arteries increased significantly.

Not all stress is negative, of course. Some of the pressures in life push us to do our best. The worst stresses are those we feel we can't control. The pressure of a deadline at work doesn't have to be overly stressful, as long as you have the time and resources you need to meet it, for instance. Negative or harmful stress occurs if you're given a deadline but not the time or means to complete it. When you continually find yourself in stressful situations that are entirely out of your control, the pressures of life can turn into harmful chronic stress.

When you're diagnosed with a serious medical problem like pulmonary hypertension, you may feel as if there's nothing you can do. But there are plenty of ways you can protect your health. There's also plenty you can do to ease the stresses of dealing with pulmonary hypertension. That's important to remember: The last thing you want to do is add to stress by worrying that tension at home or at work is harming your heart.

Immediate physical reactions to stress can include a racing pulse, sweating, and a fluttering feeling in your chest. Blood pressure climbs. Adrenaline, the biochemical that readies the body for fight or flight, surges into the bloodstream. Other typical signs of stress include the following:

•Headaches

•Insomnia

•Neck, shoulder, or back pain

•Fatigue

•Irritability

•Loss of concentration

•Loss of appetite

•An increase in cigarette smoking or alcohol consumption

•Stomach pain, cramps, and diarrhea

There is no objective test for stress. If you feel as if the pressures you face in dealing with pulmonary hypertension and other stresses in your life are a problem, it's time to do something about it.

What works best? There is no single antidote. Most people try a few approaches before finding the ones that have the best effect for them. The good news is that you won't have to turn your life upside down to tame stress, says psychologist Frederic Luskin, PhD, a researcher at the Stanford University Center for Research in Disease Prevention. "A few simple techniques, things you can do anywhere and that don't have to take more than a few minutes, can stop the stress response before it goes out of control," Luskin points out.

Here are eight strategies for soothing the savage beast of stress:

At least once every day, find a quiet corner and take five or 10 minutes to sit quietly and do nothing. Sitting quietly slows heart rate and reduces blood pressure, countering two of the most obvious effects of stress. A quiet break can also increase your sense of control over events. At the University of Massachusetts Center for Mindfulness in Medicine, patients are encouraged to sit and become mindful of how they feel and the sounds around them. Taking a quiet break like this can help you get past fatigue, which is a common symptom of pulmonary hypertension.

Shifting the focus of your thoughts from things that worry you to things that bring you happiness can change your mood for the better -- and ease stress. Psychologists call the technique "positive emotion refocusing." Thinking pleasant, calming thoughts can counteract the physiological changes that occur during stress -- you can actually slow your heart rate, for example, and lower your blood pressure.

Deep-breathing exercises have been part of meditation techniques for centuries -- with good reason. Concentrating on the act of breathing in and breathing out almost invariably calms mind and body. Some people get even more benefit from repeating a mantra-like word or phrase each time they breathe in. Another technique: Imagine each inhaled breath filling your body with soothing light. Imagine each exhaled breath blowing away tension and stress.

Laughter really is the best medicine, according to studies at Loma Linda University in California. Researchers there have shown that laughter lowers levels of the stress hormones cortisol and epinephrine. A good belly laugh also boosts immunity -- and the physiological effects can last up to 24 hours. Amazingly, the Loma Linda team has found that just looking forward to something funny helps. Telling volunteers that they would participate in an experiment that involved watching a funny video lowered their stress levels and created a more positive mood.

Having a health problem like pulmonary hypertension sometimes forces you to do things you don't necessarily want to do. The best antidote: Make time in your day to do at least one thing you really love to do -- listen to music, play music, dance, garden, play with the kids or the dog, paint, read, whatever. Listening to music may be especially soothing. At Monash University in Victoria, Australia, two groups of students were told to prepare an oral presentation. Some worked in silence. Others listened to the gentle strains of Pachelbel's Canon in D major. Blood pressure and heart rate was more likely to climb among the silent workers. Those who listened to music reported feeling much less stress. Another study, this one at the Medical College of Ohio in Toledo, found that patients who listen to music while undergoing uncomfortable medical procedures require less sedation.

Physical activity can help ease stress. If you have pulmonary hypertension, however, it's important to choose safe activities. Experts warn against lifting anything that weighs more than 25 pounds or that causes you to strain. That kind of exertion can increase blood pressure in the pulmonary arteries and bring on symptoms such as dizziness or shortness of breath. Walking is an especially good choice, since it puts minimum strain on the body. You can do it almost anywhere. And walking has proven benefits. In an investigation at the Stanford University School of Medicine, researchers looked at people who were taking care of relatives with Alzheimer's. Volunteers who began walking for 30 to 40 minutes four times a week reported feeling less distressed. Their sleep improved, and tests showed that their blood pressure was more likely to hold steady when they were under pressure.

If you notice yourself getting stressed out again and again in the same situations or because of the same problem, think about what you can change. Overwhelmed by chores at home? Work out a chore-sharing plan with other members of the household. Does your blood pressure climb every time you find yourself searching for your car keys or glasses? Decide on one place to keep them and get into the habit of putting them there. Having trouble with your boss at work? Consider sitting down to talk about the situation and offer constructive ways to make things better.

Of course some of life's frustrations and worries can't be eliminated. If you or someone close to you has been diagnosed with pulmonary hypertension, this reality is one of the things you have to live with. It's important to recognize what you can't change and move on. The process is very much like forgiving someone who has hurt you, according to psychologist Luskin. Accepting what you can't change allows you to let go of hurt and anger and to focus on more constructive thoughts.

-- Peter Jaret is a contributing editor for Health magazine and a winner of the American Medical Association's award for medical reporting. His work has appeared in National Geographic, Newsweek, Hippocrates, and many other national magazines. He is also the author of In Self-Defense (Harcourt Brace Jovanovich), Active Living Every Day, and Heart Healthy for Life.

References

First published October 27, 2003
Last updated March 11, 2008
Copyright © 2003 Consumer Health Interactive

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