REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: WHAT HAPPENS IN YOUR BODY WHEN YOU ARE UNDER STRESS?

When confronted with a difficult threatening situation (“stressor,” in 1 language of the stress physiologist), both animals and humans respond a similar manner—the so-called or flight response. Your heart rate a blood pressure increase, blood vessels in your skin constrict, muscle tension and blood flow in muscles increase, blood sugar rises, and the tendency of your blood to clot increases. In other words, you rapidly ready yourself for vigorous action. Many of the changes are triggered by your sympathetic nervous system and by a discharge of the hormone epinephrine (adrenaline) from the adrenal gland.The increases in heart rate and blood pressure together increase the heart’s need for oxygen and may bring on angina in people with coronary artery disease. The increased tendency of the blood to clot may predispose to a coronary thrombus (clot in an artery of the heart) and a resulting heart attack.In addition to this “alarm” type of stress reaction in the “hot reactor,” Dr. Eliot proposed that there is a second type of stress reaction which might best be termed “vigilance.” The firefighter hearing the alarm exemplifies the alarm type of stress, and the air traffic controller—monitoring continuously to prevent rare but tragic problems—represents the vigilant type of stress.Many people experience this vigilant type of stress on an ongoing basis: a patient (or parent or spouse of a patient) with a potentially recurring disease such as cancer, an employee whose company is undergoing a reorganization that may potentially eliminate his or her job, and anyone who lives or works with someone with a violent temper. Vigilance involves chronic, low-level arousal without the surges that characterize alarm.*275\252\8*

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