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Heart Health vs Systemic Stress

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At The Heart Of Good Health

This is Dr. Michelle Albert. She’s a cardiologist with a decades-long impressive career, recently including a term as the president of the American Heart Association. She’s the current Admissions Dean at UCSF Medical School. She’s accumulated enough awards and honors that if we list them, this email will not fit in your inbox without getting clipped.

What does she want us to know?

First, lifestyle

Although Dr. Albert is also known for her work with statins (which found that pravastatin may have anti-inflammatory effects in addition to lipid-lowering effects, which is especially good news for women, for whom the lipid-lowering effects may be less useful than for men), she is keen to emphasize that they should not be anyone’s first port-of-call unless “first” here means “didn’t see the risk until it was too late and now LDL levels are already ≥190 mg/dL”.

Instead, she recommends taking seriously the guidelines on:

  • getting plenty of fruit, vegetables, whole grains, lean protein
  • avoiding red meat, processed meats, refined carbohydrates, and sweetened beverages
  • getting your 150 minutes per week of moderate exercise
  • avoiding alcohol, and definitely abstaining from smoking

See also: These Top Five Things Make The Biggest Difference To Health

Next, get your house in order

No, not your home gym—though sure, that too!

But rather: after the “Top Five Things” we linked just above, the sixth on the list would be “reduce stress”. Indeed, as Dr. Albert says:

❝Heart health is not just about the physical heart but also about emotional well-being. Stress management is crucial for a healthy heart❞

~ Dr. Michelle Albert

This is where a lot of people would advise mindfulness meditation, CBT, somatic therapies, and the like. And these things are useful! See for example:

No-Frills, Evidence-Based Mindfulness

…and:

How To Manage Chronic Stress

However, Dr. Albert also advocates for awareness of what some professionals have called “Shit Life Syndrome”.

This is more about socioeconomic factors. There are many of those that can’t be controlled by the individual, for example:

Adverse maternal experiences such as depression, economic issues and low social status can lead to poor cognitive outcomes as well as cardiovascular disease.

Many jarring statistics illuminate a marked wealth gap by race and ethnicity… You might be thinking education could help bridge that gap. But it is not that simple.

While education does increase wealth, the returns are not the same for everyone. Black persons need a post-graduate degree just to attain similar wealth as white individuals with a high school degree.

~ Dr. Michelle Albert

Read in full: AHA president: The connection between economic adversity and cardiovascular health

What this means in practical terms (besides advocating for structural change to tackle the things such as the racism that has been baked into a lot of systems for generations) is:

Be aware not just of your obvious health risk factors, but also your socioeconomic risk factors, if you want to have good general health outcomes.

So for example, let’s say that you, dear reader, are wealthy and white, in which case you have some very big things in your favor, but are you also a woman? Because if so…

Women and Minorities Bear the Brunt of Medical Misdiagnosis

See also, relevant for some: Obesity Discrimination In Healthcare Settings ← you’ll need to scroll to the penultimate section for this one.

In other words… If you are one of the majority of people who is a woman and/or some kind of minority, things are already stacked against you, and not only will this have its own direct harmful effect, but also, it’s going to make your life harder and that stress increases CVD risk more than salt.

In short…

This means: tackle not just your stress, but also the things that cause that. Look after your finances, gather social support, know your rights and be prepared to self-advocate / have someone advocate for you, and go into medical appointments with calm well-prepared confidence.

Take care!

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