05/17/2011 04:21 pm ET Updated Jul 17, 2011

Stress 911: How Uncertainty Affects Cardiovascular Health

A State of Emergency.

The words touch on many different emotions; some at the surface, others lying just underneath.

Uncertainty brings worry. And worry often brings anxiety. Yet the physical worst for your health may be yet to come.

With the unpredictable weather patterns traversing from West coast to the East and the death of Osama Bin Laden, there has recently been an overwhelming sense of relief mixed with anxiety among the American citizenry. We're experiencing acute and chronic stress associated with uncertainty of what's to come. We have an obligation to understand that the threats of tragic weather, terrorist attacks and even disruptions in family life are real and ultimately still exist. It is a part of life.

According to the American Heart Association, every year since 1900, except 1918, cardiovascular disease has accounted for more deaths than any single faction or group of causes in the United States. A recent report indicates that more than 73,600,000 Americans suffer from high blood pressure, with heart failure affecting more than 6,000,000. There is a concurrent epidemic of stress and cardiovascular disease.

In 2008, Joel Dimsdale's article in the Journal of the American College of Cardiology, Psychological Stress and Cardiovascular Disease published a metaanalysis of the world's research literature on this unique relationship. What is clear is that stress triggers events. It is less clear if stress actually causes events. However, he documented the overwhelming evidence confirming the "deleterious effects of stress on the heart and for the fact that vulnerability and resilience factors play a role in amplifying or dampening those effects".

The heart and blood vessels are particularly sensitive to acute and chronic stress. With every beat, the heart not only pumps blood, but transmits complex patterns of neurological, hormonal, pressure and electromagnetic information to the brain and throughout the body. The heart is uniquely positioned as a powerful communication hub that connects the body, mind, emotions and spirit. Research suggests that there is an elaborate feedback network of hormones, chemicals and nerves that exist between the brain, the heart and centers of thoughts and emotions. The heart sends the brain messages that affect our perceptions, our mental processing and our feelings.

It's no surprise, then, that there is a strong connection between stress and cardiovascular health via multiple pathways including: Type A behavior pattern (hostility and anger are the lethal elements), direct effects of adrenaline on blood vessels and the heart itself (Takosabu's Syndrome), acceleration of atherosclerosis leading to coronary artery disease, abnormal metabolism, insulin resistance and inflammation, irritability of the heart muscle.

We continue to live under the potential umbrella of uncertainty. We all share an underlying conscious or unconscious apprehension of what could be around the corner. In large part this is based on the fact that what is lurking 'around the corner' may defy our inherent expectations. Think about it. You must have expectations to have certainty, which most of us do. These expectations are embedded in our routines, roles and norms in life. The same expectations that order and provide efficiency to our day today can undermine us in times of unexpected or acutely stressful events.

In fact, I want you to consider a mind shift. That it can in fact be healthy to be uncertain if you have taken the time to build certain skills what I like to call your personal 'Best Stress Zone'. I invite you to think about the benefits of being 'Mindful': anticipation and resilience. There are many experts in this field including, but let me share my view.

Consider that you can only experience unexpected disruptive events if you have expectations. But it is critical to be aware of your expectations. Expectations create a bias in how you interpret and perceive events so that your hunches are confirmed. You are very aware of the ones that you agree with and others that may trouble you and allow them to just pass by. You can loose track of 'reality'.

Awareness and attention are key elements of mindfulness. Mindfulness is a style of mental functioning characterized by having a keen awareness of context, detail and deviations from your expectations. Mindful people have the 'big picture' of the moment. It's also called Situational Awareness. It is a skill we use in the Emergency Room when we are resuscitating a patient. Mindfulness requires a certain quality of attention, and unlike situational awareness, there is a capacity to analyze and continuously refine and adjust expectations based on newer experiences. It is having the capacity to invent new expectations that make sense of unprecedented events.

Being mindful makes it less likely to misunderstand, misestimate and mis-specify what you experience. Being mindful in your BestStress Zone is also being committed to anticipation. Anticipation involves prevention of disruptive unexpected events. Mindfulness is focused on clear and detailed comprehension of emerging threats. Anticipation involves making sense of emerging patterns. Small failures have to be noticed and not simplified. Another component of anticipation associated with good heart health and stress relief is knowing your personal signs and symptoms before you leave your BestStress Zone. Do you become anxious? Sweaty palms? Forgetfulness? Easily angered? Dry Mouth? Back pain?

But the truth is, there are times when anticipation fails. Shift happens! An unexpected stressful event occurs. The stress response is triggered. That is when you finally must understand and be resilient.

Resilience involves dealing with disruptive unexpected events. Resilience involves absorbing the unexpected AND preserving function. It requires flexibility and willingness to learn and grow. It is about being able to bounce back .... not necessarily to the original point of disturbance. Resilience requires learning from failure.

It pays to be aware of your expectations, address what was unexpected and show resilience in the face of disruptive events.

Finally, learn how to relax. Truly relax. Have you had your PowerPause today?

Life can be in large part like the weather; you can't be sure of what tomorrow may truly bring, but if you address your stressors and trudges through the potential puddles, you're walking down the right path to a brighter day ahead.