Are You Too Stressed?
Wednesday, March 30, 2011
By Karla L. Robinson, MD
It is no secret that African American men have the shortest life span in the U.S. as compared to any other group.  It is estimated that the life span at birth of the average black boy is only 69 years.  This is almost ten years less than the national average.  While this disparity is certainly multifactorial, is stress one of the major players?
Let’s examine the leading cause of death among African American men, and you decide….
According to stats published by the Centers for Disease Control (CDC), heart disease is the leading cause of death overall in black men, all ages combined.  Often times we hear the term “heart disease”, but it’s not very clearly defined.  Heart disease is a “catch-all” term comprised of many conditions that cause the heart not to function properly.
Let’s briefly review some of the more common forms of heart disease affecting the African American male.
1)      Coronary Heart Disease (CHD).  This is a result of the narrowing of the blood vessels that supply the heart with blood and oxygen.  Common causes are smoking, high blood pressure, high cholesterol, and diabetes.  CHD may be manifested as angina (chest pain) or it may lead to heart attacks.
2)      Hypertensive Heart Disease.  This group encompasses all of the heart complications related to uncontrolled high blood pressure.  Some common diseases include:
    * Congestive heart failure- poor muscle function of the heart preventing appropriate pumping action
    * Hypertrophic heart disease- overgrowth of the heart muscle leading to poor muscle contraction and pumping action
    * Ischemic heart disease- the thickened overgrown heart muscle does not have the blood supply it needs to function correctly
    * Acquired valvular heart disease- the valves controlling the flow of blood through the heart chambers aren’t functioning  appropriately
3)    Cardiomyopathy. This form of heart disease is related to a weakening of the muscle structure of the heart.  Some common forms of cardiomyopathy include:
    * Dilated cardiomyopathy- an overstretched heart muscle, with poor pumping ability leading to pooling of blood and/or clot formation in the heart.  Can be caused by coronary artery disease, diabetes, infection, obesity, drugs, or alcohol abuse. This can lead to congestive heart failure, or stroke as clots formed in the heart travel to other areas of the body
    * Hypertrophic Cardiomyopathy (HCM) - an overgrowth of the structures of the heart.  As a result the heart muscle becomes thickened. This condition can lead to ineffective blood flow from the heart to other parts of the body.  In one form of this disease, there is the overgrowth of the wall separating the ventricles of the heart.  This anomaly prevents blood flow out of the heart particularly at times of exertion or when the heart muscle is pumping at high speeds.  This condition is often times the cause of sudden death in the young black male athlete.
OK, so how does stress fit in?
Stress has long been known to be linked to obesity.  In a recent study published in the American Journal of Physiology-Regulatory, Integrative, and Comparative Physiology, a research team from the University Of Cincinnati College Of Medicine proved that everyday stress can result in measurable, sustained weight gain.  When individuals are stressed there is a tendency to overeat.  Many under stress may eat less often, however consuming much larger meals each time, often leading to weight gain.
Research has also discovered evidence that certain hormones are a factor when under stress, and can contribute to obesity.  Cortisol, a hormone that is released throughout the body when under chronic stress, is a known appetite stimulant and a major contributor to fat storage in the body.  Serotonin or our “happy hormone” is increased by eating a meal high in carbohydrates. When under stress, our bodies may be craving foods in order to feel better….”comfort food”.
Not only is obesity a major factor in hypertension, diabetes, and high cholesterol which are known to cause heart disease, it is also an independent factor for the increased risk coronary heart disease.
Men, are we literally stressing ourselves to death?
While it is known that a lot of societal stress is beyond our control, we can all do a better job at reducing stress in our own lives. Here are some practical stress reducing techniques that perhaps we should all put into practice more often.
    * Identify your stressors. How can you change or eliminate them if you don’t know what they are?
    * Avoid the stressors you can, change your reaction to the one’s you can’t. There are some stressors that we simply can’t avoid, but try not getting as worked up about them next time.  Try to see the positive spin in every situation….not easy, takes practice.
    * Avoid smoking, drinking, and drug use. Many turn to these vices as a means to cope when stressed.  Not only do these behaviors further contribute to your risk of heart disease, they don’t even eliminate the stress.
    * Exercise. Having a regular exercise routine is a great stress reliever.  It will help you feel better, look better, and decrease your risk of developing heart disease.  Aim for a goal of at least 45 minutes per day, at least 4-5 days per week after consulting with your physician.
    * Laughter. There is nothing wrong with unwinding and having a good time.  Laughter has been shown to reduce the levels of stress hormones in the blood.  Laughter really is the best medicine.
    * Manage your time wisely. Take charge of your schedule.  Don’t over commit.  Know your limits, and learn to say “no”.  Prioritize and do things in order of their importance.
    * Make the time to do the things you enjoy. Whether it’s hanging out with family, golfing with buddies, or another hobby, be sure to remember to make time for you.
Stress- Urban Legends
1. Stress in normal and there is nothing we can do to prevent it. While potentially stressful things and events are prevalent, our response to them is what determines our “stress level”.  We can prevent some of the stress we experience by avoiding the stressors that we can, or by changing our reaction to the stressors that we can’t.
2. Stress shows up the same way in everyone. This is untrue.  Many may have physical manifestations of their stress (physical aches and pain, abdominal pain, nausea, headaches), while others may have a more psychological manifestation (depression, anxiety, anger etc.)  Every person’s response to stress is different, and it differs in the same individual depending on the stressor.
3. I don’t have any major symptoms of stress, so I must not have it. There can certainly be an unhealthy amount of stress before major health symptoms appear.  If you are using alcohol, and/or drugs regularly you may be self-treating stress in your life.  If you are experiencing minor symptoms of stress, these may be the warning signs that things are starting to get out of control and it is the best time to reevaluate stressors in your life.
4. If I ignore the symptoms of stress, they will eventually go away. Stress will not go away on its own.   It takes a conscious effort by you to change the stressors in your life.  Ignoring the signs or stress may lead to worsening of the manifestations of stress.  Take the time toaddress these issues today, before it is too late.
5. Stress is necessary to perform well. This can’t be further from the truth.  There is a distinct difference between stress and motivation.  Having goals and pushing yourself to reach them can be considered motivating factors.  Experiencing anxiety, the inability to concentrate, and extreme frustration while trying to accomplish a goal is considered stress and often times leads to poor performance.  For some who are still able to reach their goals under these circumstances, it is often times in spite of stress, not because of stress.
March 27, 2011 - April 9, 2011 Edition 

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