Running head: Chronic Stress & Coronary Heart Disease

The Relationship Between Chronic Stress & Coronary Heart Disease: A Meta Analysis
Chloe Zaharko
Northeastern University

Chronic Stress & Coronary Heart Disease

Context Note
This paper is meant to be a researched argument/ research proposal in the form of a
scholarly essay. There are multiple different fields of study that are applicable to, and appropriate
for this topic. With respect to this paper the two primary fields of study are psychology and the
medical field as a whole. As this topic is multifaceted, it has potential to be published in many
different journals. More specifically journals such as; Journal of Developmental Psychology,
Journals of the American Psychological Association, Neurobiology of Stress Journal, Journal of
Early Intervention, Journal in Cardiovascular Diseases, International Journal of Stress
Management, Journal of Health and Social Behavior, in addition to many others. The audience of
this paper is mostly psychologists interested in the stress response, but also medical professionals
interested in CHD. This topic is relevant to both medical and psychological fields of study
because it pertains to the brain and the heart.
To make this paper clear to its reader, here are a few explanations of various terms used
throughout the document. CHD is the acronym used for Coronary Heart Disease. The Life
Course Perspective refers to a multidisciplinary methodology that explains the physical, mental
and social health. Which also integrates knowledge of early life span development, and life
course health trajectory. The ACE Study stands for The Adverse Childhood Experience Study.
The parasympathetic nervous system is involved in resting and digesting, processes that
slow/calm the heart rate, blood pressure, and respiration. The sympathetic nervous system is
known for engaging the fight or flight response, so increasing heart rate, acceleration respiration,
and secreting necessary hormones.

Chronic Stress & Coronary Heart Disease

Abstract
This paper explores the very complex relationship between coronary heart disease and
chronic stress. Previously conducted research demonstrates that chronic stress has a

negative influence on the cardiovascular system, in turn resulting in/exacerbating coronary

heart disease. Due to the fact that todays society is largely based around health, it is sage
idea to explore this topic further with hopes of creating an overall health conscious culture
and to preserve our preexisting health philosophy. By reviewing the data from five articles
this paper seeks to provide a proposal for future research. Via prioritizing the health of
humanity starting with childhood stressors, this paper looks at the ACE Studies as a new
age factor to be considered. As little is known about what causes individuals to be
susceptible to various diseases, it is imperative that more longitudinal research on chronic
stress and CHD is conducted; in addition to implementing comprehensive plans to combat
stress from a life course perspective.

Chronic Stress & Coronary Heart Disease

The Relationship Between Chronic Stress & Coronary Heart Disease: A Meta Analysis
The connection between the mind and the body has proven to be an interesting and
widely sought after topic in the field of psychology. In todays society where technological
advances have led a plethora of research in the medical field to be conducted, there is a desire to
know more about what influences or exacerbates various medical conditions. One topic in
particular that highlights this association is the relationship between chronic stress and various
illnesses, more specifically, heart disease. Many factors are said to influence an individuals
susceptibility to disease, however, is it possible that chronic stress increases this risk? The
answer to this question is, yes, studies show that chronic stress has lasting effects on the bodys
immune system. Comparatively, there is little evidence surrounding the primary structures
responsible for these effects. From a psychological perspective, a comprehensive investigation of
previously conducted research, coupled with new research, has great potential to bridge the gap
between the mind and the body. With hopes of eventually minimizing or even eliminating many
preventable issues, there is a strong gap in knowledge surrounding this topic. Additional
longitudinal research on chronic stress would assist in a more comprehensive understanding of
the psychological factors that cause or aggravate coronary heart disease.
Evidence
Although the word, stress has several meanings, according to the American
Psychological Association stress is defined as, any uncomfortable emotional experience
accompanied by predictable biochemical, physiological and behavioral changes (Alvord et al,
n.d.). In todays society where chronic stressors come in many different shapes in sizes, it is
believed that such stressors are linked to coronary heart disease, or CHD (Miller & Blackwell,
2006). One research study conducted by Mathews and Gump in 2002 shed light on the

Chronic Stress & Coronary Heart Disease

relationship between stress and coronary heart disease. The aforementioned researchers studied
12,000 male participants over the course of 9 years. Results of this study indicated that
individuals who experienced prolonged complications at home or in the workplace, were 30%
more prone to a CHD related mortality (Miller & Blackwell, 2006). In essence, if an association
is made between difficulties or problems in ones life, and the prevalence of a casualty caused by
CHD, it makes sense that such information should be examined in greater detail. When
examining data such as the figures above, looking at this type of information through a different
lens would be beneficial. This information helps to solidify the notion that chronically stressed
individuals are predisposed to develop and suffer complications from coronary heart disease.
The link between chronic stress and physical ailments is complex, and could benefit from
an all-encompassing approach. In this case examining the topic from the ground up, using a life
course perspective would be advantageous. The Adverse Childhood Experience study, or ACE
study is a prime example of why, the structural, social, and cultural contexts should be used as a
starting point from which to analyze. The ACE Study is one of the largest ongoing analyses, and
was pioneered by the CDC and Kaiser Permanente. This study was intended to evaluate and
measure the relationship between damaging childhood occurrences, and their effect on healthcare
issues that follow in subsequent years. Data from over 17,000 individuals was collected, which
indicated certain experiencesincluding childhood abuse, neglect, and exposure to other
traumatic stressorsare risk factors for some of the leading causes of morbidity and mortality
(Existing Measures, 2001, p. 25). Distressing incidents during childhood are linked to
prevalence of chronic illnesses in adulthood. Whether shaped socially or domestically, these
manifestations create a foundation for which other stressful events to arise, by increasing the
probability of diseases in adulthood. Therefore, refining and developing programs about sage

Chronic Stress & Coronary Heart Disease

health outcomes for children and adolescents, is an integral stepping-stone in building a healthy
culture for the community at large. By creating a solid foundation that not only educates but
provides a framework of how to combat such stressors and cope with related matters, society
becomes one step closer in the fight to extinguish illnesses occurring in adulthood. It is
increasingly important to create awareness surrounding the known root causes of such health
ailments, as accomplished in the ACE Study.
The Impact of Stress on the Cardiovascular System
At a fundamental level, the cardiovascular system is made up of the heart and blood
vessels. According to the American Psychological Association, these two key aspects work in
conjunction with one another to feed the bodys organs with necessary nourishment and oxygen
for efficient functioning. Consequently, chronic exposure to stress is said to increase the risk of
prolonged troubles with the heart and blood vessel. These heart and blood vessel problems can
be attributed to excessive secretions of stress hormones, and constant rise in heart rate; such
factors are known to be associated with high blood pressure, and risk of stroke or heart attack
(Tovia, Stress Effects, n.d.). In other words, the impact of stress on the cardiovascular system is
validated by the fact that stress leads to excessive hormone secretions and other physiological
complications revolving around the blood vessels in the heart. Which is why it is important to
assess all of the risk factors that contribute to certain illnesses. Without the scientific data to back
up the impact of stress on the cardiovascular system, medical professionals would not have a full
realm of knowledge on such topics. Therefore leaving many unanswered questions surrounding
important topics in health, and prolonging solutions to such findings.
There are several explanations for why stress has a negative influence on the human
body. One of the main reasons that stress has such a substantial impact on the body is that certain

Chronic Stress & Coronary Heart Disease

physiological symptoms are elicited when an individual experiences stress, and chronic stress. Of
the systems activated when stress develops, one main system is the fight-or-flight response.
When the fight-or-flight response is engaged following the onset of a stressful event, the
sympathetic nervous system triggers the bodys cardiovascular system to go on high alert, and
the adrenal glands secrete hormones called catecholamine (Jansen et al, 1995). If an individual is
chronically stressed, these physiological responses are elicited more frequently than needed. The
prolonged usage of such processes in the body leads to an overextension of the sympathetic
nervous system, and an underutilization of the parasympathetic nervous system. The responses to
stress elicited by the cardiovascular system are interwoven with many other physiological
processes. However, when there is a continual strain on the cardiovascular system it creates a
susceptibility to deterioration, making it only functional to a certain degree. Stressed individuals
often engage in the rumination of their feelings, especially if the stressor is ubiquitous, in turn,
generating lasting negative effects on the heart (Dimsdale, 2008). Of the many impacts that stress
has on the cardiovascular system, although complex, the processes discussed above help to break
down this medical concern piece by piece.
Course of Action
The adverse experiences and behaviors children are subjected to during their youth, play
a major role in health outcomes later in life. The prevalence of these unfavorable experiences
affecting the nations wellbeing can be used as motivation to combat these issues. Outlined in
Childrens Health, Nations Wealth, there is a strong need to implement programs that reinforce
resiliency and focus on predominant risks increasing an individuals susceptibility to unfavorable
health conditions (Existing Measures, 2001, p. 25). Creating awareness about the pertinence and
longevity of these issues will help society to be more cognizant of stressors in the future. One

Chronic Stress & Coronary Heart Disease

solution to this problem would be to spearhead informational programs in school settings to help
children better cope with stressors. Equally, programs designed to educate teachers, coaches,
instructors etc. on how to look for warning signs and how to effectively deal with such situations.
Although these programs would serve as a form of tertiary prevention, they would create
awareness about this taboo societal issue. In addition to this, access to health care, adequate
shelter/living space, social networks, a nurturing family, support systems, public awareness
campaigns, and communities who play a role in providing support for families; would all be
plausible solutions to put a dent in preventing the manifestation of stress and its related
symptoms.
Counter-Perspectives
When examining past and previous research, many factors must be taken into
consideration when considering ulterior rationalizations for medical symptoms. Stress impacts
not only the cardiovascular system, but also the musculoskeletal, respiratory, endocrine,
gastrointestinal, nervous, and reproductive systems (Tovia, Stress Effects, n.d.). Therefore,
chronic stress could be examined through many different lenses. From pre-existing data, it can be
concluded that individuals battling health issues are predisposed to lead a more stressful lifestyle.
Implying that these individuals are more inclined to engage in stressful thought processes,
activities, behavior, and other taxing ways of life. Which could serve as another reason why such
individuals develop coronary heart disease. Similar effects are also attributed to genetics, the
environment, or other outside forces such as depression. Despite the fact that there is a great deal
of data to support the link between chronic stress, CHD and other cardiovascular ailments, there
is still a possibility that these factors could be credited by other external influences.

Chronic Stress & Coronary Heart Disease

In the field of psychology, the connection between the mind and the body is a highly
regarded topic, and has always been a sought after matter to study. There is still a great deal of
ambiguity surrounding how the mind and body affect one another physically and
psychologically, and there is much headway to be made on this forefront. However, research on
chronic stress and coronary heart disease indicates a strong connection between the two. This
research is significant in the sense that, it illustrates areas where further research can be
conducted and what changes need to be put into action. While on the precipice of bridging
research and making a course of action, this topic is extremely important for the future. As seen
in the ACE Study and all other research discussed in this paper, there is much data backing this
relationship. In addition there are various reasons why such claims are supported in the medical
field. Although many factors influence an individuals vulnerability to disease, it is unlikely that
chronic stress and heart disease are unrelated. When issues concerning the future health of
society arise, it is important to look at them in a way conducive to solving the problem. All
research outlined in this document is highly important in the search for a greater understanding
on how chronic stress affects CHD. The ACE studies provided an exemplar life course
perspective with regards to examining the issue of exposure to stressors, starting in childhood. If
additional longitudinal research is conducted on the primary structures affecting chronic stress,
coupled with newly implemented programs to combat childhood stress, positive implications on
psychological and physical health will be seen.

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Works Cited
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