I was recently invited to a series of talks on how to prevent and treat cardiovascular diseases like high blood pressure, heart failure and other types of heart diseases by drug and nondrug treatments.

Before the doctor prescribes medicines, he or she makes sure that the patient fully understands and is convinced that lifestyle changes are needed to prevent heart attacks, strokes, heart failure and other cardiovascular complications.

This is frequently referred to as TLC, not tender loving care (although doctors are also encouraged to practice it), but therapeutic lifestyle changes. This comes in the form of a healthy diet, increase in physical activity, and relaxation or management of one’s stress.

We used to think that stress is not that serious a risk factor in causing serious heart ailments. There are now increasing reports worldwide on a type of heart failure related to severe stress, which was first reported in Japan in the 1990s.

It’s called Takotsubo Cardiomyopathy, which occurs usually in women in 90 percent of cases, 30 years and older, following an episode of severe stress or grief.

Some cases published or presented in international conferences attribute it to a recent separation with the spouse or breakup with the boyfriend.

Women with no previous history of heart disease may not be diagnosed properly when they are rushed to the emergency room for severe chest pains and difficulty in breathing.

Stress trigger

Hence, physicians should give cases of young women experiencing heart-related symptoms the benefit of the doubt, even if it appears to be just an anxiety reaction, and request some basic tests to rule out a possible heart problem. It can be reversed if recognized early enough, and treated adequately.

The problem is that many of these women are sent home without a thorough examination and basic work-up. Unfortunately, their symptoms are dismissed as an anxiety reaction since there is an identifiable stress trigger. Thus, their heart failure can progress and may lead to an untimely death.

Unmanaged stress has also now been identified as an important aggravating factor in cases with difficult-to-control high blood pressure. Some people with high blood pressure are already taking three to four drugs for their condition, and yet the blood pressure may remain suboptimally controlled, thereby putting patients at risk for serious complications.

Some centers in the US and Europe now have clinics which specifically address the stress problems of patients. Laugh and music therapy are being recommended in many of these clinics.

There’s so much truth to the old adage that “laughter is the best medicine.” Laugh therapy, in which participants are made to do belly-laughter exercises, which may be dubbed as artificial laughter, has been shown to produce significant benefits.

Not only does it help control the blood pressure and chest pains of many participants, it can help boost the immune system, strengthening resistance to infections.

It also helps release substances that open up the blood vessels for better circulation, as well as the so-called feel-good hormones, endorphins.

Also, by listening to classical music, particularly that of Wolfgang Amadeus Mozart, one can enjoy stress-relieving and even therapeutic effects.

Improvement

A group of Italian investigators has shown that patients with severe chest pains and heart attack experience significant improvement, on top of the effects of the medicines they were given, from listening to the soothing sonatas of Mozart for 20 minutes.

Parameters of improvement of the circulation both in the big arteries (macrocirculation) and the small arteries (microcirculation) have been demonstrated.

Last June, German researchers published their report that hypertensive and nonhypertensive individuals listening to Mozart music for 20 minutes also showed a modest but remarkable drop in the blood pressure, compared to those who listened to other genres of music.

Even those with normal hearts, and mild heart disease can benefit from it.

So, excuse me while I listen to Mozart’s Sonata for Two Pianos in D major.