Stress and Cholesterol
Stress has been blamed for most of the ailments that plague us humans, and in many instances there is reasonable evidence to support the role of stress in a multitude of diseases. Can stress cause high cholesterol?
Can Too Much Stress Cause A High Cholesterol Level?
Since elevated cholesterol levels and the related cardiovascular diseases are so prevalent in our society, and since excessive stress is a fact of life for most of us, one would think extensive research looking at the
relationship between stress and cholesterol has been done. A review of the medical literature available to date (June '06) reveals a surprisingly low number of studies on this topic. One of the reasons might be that stress is a rather difficult parameter to quantify with any degree of precision, and thus performing clinical studies with stress as the independent variable is a challenging undertaking.
This being said, there are a few studies out there providing some fascinating insights into the relationship between stress and cholesterol levels.
Preoperative Stress Can Elevate Cholesterol Levels
Back in the '70s, when the ill effects of high serum cholesterol were being decifered, a couple of researchers had the brilliant idea to investigate
what happens to blood cholesterol levels when people go to the hospital for a surgical intervention. They ended up studying a total of 65 patients in whom they measured serum cholesterol levels before the surgery and at the time of discharge from the hospital. The preoperative rise of cholesterol varied from 40 to over 50%.
This finding has some interesting implications for people who are diagnosed with elevated cholesterol levels during a hospital admission. If the numbers are high enough, these patients are often started on cholesterol/lipd lowering medications in the hospital, and they are then discharged with instructions to continue to take these drugs for the rest of their lives. Cholesterol testing should better be done on an outpatient basis, and therapy, unless deemed imperatively necessary right away by a qualified physician, should be preceeded with therapeutic lifestyle changes, such as changes in diet, exercise, etc. These changes, if implemented adequately, can often have a significant impact on serum cholesterol levels - in fact, they were shown to be as effective as statins.
Other Types of Stress Cause High Cholesterol
- Exam-Related Stress
A team of indian researchers tested 12 students exposed to varying degree of examination stress. They found that "serum cholesterol and triglycerides exhibited a rise proportional to degree of examination stress, whereas total lipids exhibited an initial rise followed by a fall. Values of all these parameters attained control level when the stress was over."1
- Chronic Psychological Stress
In Japan, a group of reseasrchers measured serum cholesterol, along with other parameters, in 34 victims of the Tokyo subway sarin poisoning incident. Eight of the 34 developed post traumatic stress syndrome. The authors noted: "No significant relationship was observed between PTSD and serum cholesterol..."2
- Job (Occupational) Stress
Many of us consider our jobs stressful, and one may wonder what this stress is doing to our health. In the context of our article, does one have to fear chronic occupational stress increases cholesterol levels? Surprisingly, there have been very few studies on this topic.
Using data from a survey of 964 white-collar Taiwanese workers (438 women, 526 men), a team of researchers examined the relation between job strain and cardiovascular risk factors (high serum total cholesterol, low serum high-density lipoprotein (HDL) cholesterol, and high plasma fibrinogen). Again, there was "no consistent association between job strain status and total serum and HDL cholesterol."3
- Physical Stress / Training
What about extreme physical exertion or stress? Do military trainees, for example, have to fear their intense training adversly affects their blood cholesterol levels?
The reality is physical activity, even in its more extreme forms, has positive, rather than negative effects on blood lipid levels. In an article entitled Changes in lipoprotein profiles during intense military training, scientists from the Department of Military Medicine, Uniformed Services University of the Health Sciences in Bethesda, MD found that navy trainees undergoing intense military training experience some rather desirable changes in their blood lipid profile: "After physical conditioning, serum total cholesterol and triglyceride concentrations were unchanged, while high-density lipoprotein (HDL) concentrations increased 31%. After 5 days of severe stress, total cholesterol and low-density lipoprotein concentrations decreased 17.2% and 30%, respectively, whereas HDL concentrations increased 12.1%." These findings should be encouraging for those trying to improve their cholesterol numbers - but you should remember it takes hard physical work to reap these benefits.
My take on this topic is that stress is probably not a major determinant of cholesterol levels. What we eat, how much we exercise and our genetic makeup seem to be the big players in the lipid profile ecuation. However, there is a lot of room for serious, large-scale studies before we can give a precise answer to the question "How much does stress affect blood cholesterol levels"...
Until then, try to take it easy :-)
Dr Gily
