Everyday Mindfulness

A Cardiologist’s Advice: Emotional Intelligence Can Protect Your Heart

For millennia the heart has been portrayed as the seat of our emotions. While this imagery has been popularized in art and literature, modern neuroscience and cardiovascular research have only recently begun to explore the connection between human emotions and physical health. 

Over time, our hearts are literally shaped by our emotions and moods. Just as we now know we can rewire our brain’s connections using specific practices (a process known as neuroplasticity), the structure and function of the heart may undergo changes in response to our emotions: one form of a process known as cardiac plasticity. 

Balanced Mind, Strong Heart 

Difficult emotions are shown to risk harming the physical heart. For example, a 2014 meta-analysis of 30 prospective studies (40 independent reports), with 893,850 participants and follow-ups ranging from 2 to 37 years, found that depression predicted the excess risk of developing coronary heart disease or heart attack. Anxiety, traumatic events, anger, frustration, and unrelenting job stress all pose similar cardiovascular risks, and likely share a common physiologic pathway. 

The most extreme example of negative emotions impacting heart health is a condition known as stress cardiomyopathy, commonly referred to as “broken heart syndrome.” In this condition, the physical heart weakens and sometimes fails as a result of extreme grief, emotional distress, or surprise. The risk of heart attack increases 21-fold within 24 hours after the loss of a loved one. 

Conversely, research has shown that positive prosocial emotions like gratitude, optimism, and empathy can have the opposite result, reducing stress and helping the heart enter a state of balance and calm. Optimism, life purpose, and positive affect have been linked with reduced risk of developing coronary heart disease (CHD). In one large trial, 97,253 healthy women were followed for over eight years. Optimists were found to have a lower risk of CHD, including 30% lower CHD mortality, and 14% lower total mortality. Those with higher levels of cynicism and hostility were found to have a higher risk of early death, either from cancer or other causes. 

While we may not be able to control some factors in heart health, such as the genes we inherit, understanding the connection between emotions and cardiovascular health allows us to cultivate the emotions that nurture both our emotional and physical heart.

A Change of Heart

In order to understand how emotions impact our bodies, it’s important to know where they come from. 

Many of the factors of stress reactivity begin in the mind. It is our perception and interpretation of events and our experiences—the meaning we make consciously or subconsciously—that determines our thoughts, feelings, and behaviors. 

There are three overlapping mechanistic pathways, found in our mind, body, and behavior, linking stressful emotions, psychological well-being, and cardiovascular health. Let’s take a brief ride along the mindheart highway. 

First let’s look at where emotions come from, then we can unpack the difference between feelings, emotions, and moods. 

Emotions—primal, unconscious bodily responses—originate in a matter of seconds from the limbic centers of the brain (e.g., the amygdala), providing information to the more modern and uniquely human prefrontal cortical centers responsible for meaning-making and planning. 

Emotions then give rise to feelings. Contrary to what we might believe, emotions are different from feelings, says Antonio Damasio, chair in neuroscience, as well as professor of psychology, philosophy, and neurology, at the University of Southern California. According to Damasio, feelings are the meaning we give our emotions based on our memories and beliefs, and the subjective labeling of our experiences. For example, if we are called on to speak in public, we might experience emotional responses such as a faster heartbeat, tense muscles, and a sensation of butterflies in the stomach. These physical sensations are then interpreted by our conscious mind, which labels them as a feeling: “fear.” 

Our emotions help the body move toward self-protective action.

Moods are the constellations of emotions and feelings that may have no connection to an initial triggering event, and can last for days or more. When we have recurring emotions and feelings and begin to identify with them—seeing an emotion as part of who we are—we may not be consciously aware of them, because they seem like constant companions instead of information that arises and passes.

How Emotions Propel Us

Our emotions help the body move toward self-protective action. Even the root of the word emotion reminds us of this—e movēre, from the Latin word meaning to move outward. To better understand this, let’s explore how emotions crucially connect our brain with our body. 

All emotions set off a chain reaction of electrical and chemical signals from the brain, which travel throughout the body along the autonomic nervous system (ANS). Our organs are all programmed to receive these physical signals and have receptors covering their surfaces. This is why a single emotion like stress can trigger signals that result in inflammation and blood platelet activation (tendency toward blood clots), and cause our cells to age more rapidly. 

Emotions also affect the function of the brain itself, influencing our ability to focus, our patterns of thought, our levels of energy/motivation, our ability to sleep, and even our appetite. 

Which brings us to the final stop on the mind-heart highway: the behaviors triggered by our conscious and unconscious impulses that our emotions influence. Our mental state determines our tendency toward or away from selfcare, our adherence to healthy lifestyle choices, and our likelihood of developing and maintaining a supportive social network. 

Research has shown that our personality, which can encompass many of our default ways of reacting to the world, is a risk factor for heart disease. 

Many of us might have heard about the link between having a Type A personality and developing  heart disease. However, more recent studies have shown that it’s only certain Type A traits that may increase cardiovascular disease risk: depression, anxiety, anger, and hostility are all strong factors increasing the risk of developing heart disease, with depression being the strongest contributing factor. 

Here’s the good news: With practice, we can rewire certain aspects of our default patterns of emotional reactivity.

Strengthen Your Heart and Emotional Wellness

The American Heart Association identifies seven primary determinants of cardiovascular health. They include tobacco use, nutritional choices, level of exercise, body composition, blood pressure, cholesterol, and blood sugar. Where we fall on the behavior spectrum (e.g., unhealthy vs. healthy, maladaptive vs. adaptive) will determine how many of these indicators we have. Over time these behaviors and shifting parameters can result in heart-related symptoms and adverse health events, or lack thereof. 

While we cannot draw neat lines between where our mental health ends and our physical health begins, understanding this connection between our emotional state and health-related behaviors can improve our heart and general health. By learning to become mindfully aware of our inner state, we can literally help protect our hearts.

Cardiologist Jonathan Fisher leads a body scan to notice sensations in the body and bring awareness to the present moment.
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