"The Heart of the Matter"

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Week: 520.3 Guest: Louis Grenzer, M.D. Topic: Stress and Heart Disease - One Part Host: Richard Roeder Producer: Ed Graham

ROEDER: This is a discussion about the effect of stress on heart disease. My guest is cardiologist Dr. Louis Grenzer from Baltimore, Maryland.

ROEDER: Dr. Grenzer, you have been a cardiologist for 25 years so you certainly have seen a lot people come and go and come through your office. This is something that is written about often - stress and heart disease and there certainly are amazing contradictions in the studies that come out. Some say that after all that belief there is no such correlation. I really am much more interested in the opinion of someone who's actually in the trenches doing it. How much does stress contribute to heart disease?

GRENZER: I don't think there's any question that stress is one of the very important risk factors in getting heart attacks and developing heart disease. It is clear that for instance certain occupations are very closely related to heart disease and the ones that come to mind are policemen, prison guards and firemen. I do a good amount of examinations of patients for workmen's compensation examinations and I see firemen and policemen all the time, younger people who develop heart attacks and it certainly has to be related to the stress of their job. By the way, people who work in the post office - maybe not quite as well recognized but we get a lot of patients from that occupation so they must be put under a lot of stress as well. I've certainly over the years seen a number of patients who've acutely developed a heart attack at the time of a severe stress. I had a policeman who had to notify a family about a death from an auto accident who within minutes after that developed a heart attack. I had a patient once who actually owned a music store. It caught on fire and burned down before his eyes and he had a heart attack on the spot watching that happen. And I had another patient that comes to mind whose wife had just had a miscarriage and on the spot he had a heart attack. So it can sometimes happen very acutely but of course the other thing to bear in mind is that stress over months and months certainly can lead to heart attacks. I don't think anyone who's practiced cardiology for any period of time would question the fact that stress is one of those very critical risk factors in developing heart disease.

NEMA: Now, how much have you seen on the other side of the coin, how much have you seen patients who took up things like meditation or relaxation techniques helped by those techniques?

GRENZER: It's a lot harder to tell if someone has been helped because of the great variability of heart disease. We see people who have a heart attack and do well for many years thereafter without any specific intervention such as that but I have, for instance, myself seen patients who particularly if their job is stressful retire and go to another job and it seems to me that those patients have done much better when they have been taken out of the stressful environment. That's a lot harder one though I think to prove but certainly anything that you can do to relieve stress I think would be helpful, whether it be meditation, changing your job or whatever is necessary. Of course, some of those things are hard to do. People can't just quit their job because they're under stress in most cases.

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