Professor Giulio Stefanini, specialist in clinical and interventional cardiology at Humanitas and lecturer at Humanitas University, was a guest on the live Facebook stream of Obiettivo salute on Radio 24 to talk about heart health. A lot of time has been given to the link between the heart and stress, but the professor also spoke about risk factors and signals that should not be underestimated.

“Stress weighs on the health of our heart because it has an impact on blood pressure; a continuous stress in fact increases the values of blood pressure that have a direct effect on cardiovascular risk. It should also be noted that stress affects the risk of coronary events since it leads to changes in the atherosclerotic (cholesterol) plaques in the coronary arteries, which may eventually break with the risk of an ischemic event such as a heart attack occurring. Stress induces a series of hormonal stimuli that can be associated with the risk of breaking the coronary plaques.


Acute stress and continuous stress

“It is good to differentiate between episodes of acute stress and a stimulus of continuous stress over 24 hours that also leads to a stabilization of the pressure values a bit higher. Eliminating stress, perhaps organizing our days better, can help a lot. This is clearly not enough, especially if we are faced with a pathological situation such as high blood pressure.

Consultation with a neurologist or psychologist can help you assess your stress level; while from a cardiological point of view we can measure blood pressure. We know that a stressful life can lead to an increase in blood pressure and we can take action both by eliminating stress and by promoting regular physical activity that helps to reduce blood pressure levels and finally, if necessary, proposing appropriate treatment.


Palpitations: when to be alarmed?

“Some palpitations – which is often a reflection of the heart going faster or an extrasystole – are not by themselves a pathology and therefore we should not be alarmed. A symptom of this kind, especially if prolonged, can be the manifestation of pathologies such as an arrhythmia and therefore must be investigated.

It is good to remember when the symptoms occurred because this can provide valuable information on the meaning of the symptom itself. To investigate these symptoms, a 24-hour Holter may be indicated, or a full-day electrocardiogram recording. The patient will write in a diary the possible presence of symptoms and what they are associated with. The cardiologist then analyses the electrocardiographic trace and relates it to the symptoms written in the diary.


Modifiable and non-modifiable risk factors

In general, it is recommended to lead a healthy lifestyle, keeping body weight in normal condition, following a balanced diet and “doing regular aerobic physical activity at least three times a week for 45 minutes; it is advisable to walk quickly, run, swim or ride a bike. There is no need for excessive effort, but it is important to get your heart used to working properly throughout the week.

Being obese or overweight is a cardiovascular risk factor in all respects, but it is a modifiable factor on which we can act to eliminate it; smoking, hypertension and high cholesterol are also modifiable risk factors. The unalterable risk factors are age, sex and genetics.

In the presence of the following signs it is good to consult a cardiologist: pain that was not felt before, chest oppression or oppressive chest pain that lasts a few minutes and is usually associated with effort and fatigue, and sudden fatigue in performing activities that have always been carried out without problems,” concluded the specialist.

Other topics addressed by Prof. Stefanini included the differences between men and women in the field of heart disease, the progress made in research and what precautions should be taken when a patient has had a heart attack.


Watch the live stream with Professor Stefanini: