Being exhausted to the point where you’re fed up with your life and feel grouchy and hopeless much of the time isn’t just a miserable way to live — it’s also bad for your heart.
You may be so burned out that you have an increased risk for atrial fibrillation, a potentially fatal heart rhythm disorder, according to a study published in January 2020, in the European Journal of Preventive Cardiology.
The study followed 11,455 people starting when they were 57 years old on average and had no history of atrial fibrillation. After a median follow-up period of about 23 years, 2,220 people, or about 19 percent of the participants, developed atrial fibrillation.
People with the highest levels of burnout at the start of the study were 20 percent more likely to develop atrial fibrillation than participants with little or no evidence of exhaustion.
"Vital exhaustion, commonly referred to as burnout syndrome, is typically caused by prolonged and profound stress at work or home,” says lead study author Parveen Garg, MD, MPH, of the University of Southern California in Los Angeles.
“It is already known that ‘exhaustion’ can be harmful for one’s mental health, but our findings suggest that it may also adversely affect one’s heart health,” Dr. Garg says. “Exhaustion increases one’s risk for cardiovascular disease, including heart attack and stroke, and also now, based on our results, for atrial fibrillation.”
How People Develop Atrial Fibrillation
Atrial fibrillation is the most commonly diagnosed heart rhythm disorder. As of 2010, an estimated 33.5 million people worldwide had the condition, according to a study published in the journal Circulation. Their ranks are projected to swell as the global population ages.
A healthy heart relaxes and contracts in a steady rhythm to pump blood through the body. When people develop atrial fibrillation, their heartbeat becomes irregular and often rapid, increasing their risk of problems like blood clots, strokes, heart failure, and death from cardiovascular problems.
Old age is a risk factor for atrial fibrillation. Other risk factors include:
- A family history of the disorder
- Heart disease
- High blood pressure
- A drinking problem
- Respiratory diseases, like chronic obstructive pulmonary disorder (COPD)
In the current study, researchers set out to assess whether several psychological problems indicative of extreme stress or burnout might also be associated with an increased risk of atrial fibrillation.
They assessed vital exhaustion, or burnout, based on how often people experienced a wide range of symptoms, including fatigue, poor sleep, lack of energy, limited concentration, crying spells, hopelessness, irritability, decreased libido, depression, or suicidal thoughts. They also looked at whether people took antidepressants, experienced frequent bouts of anger, or suffered from social isolation.
Antidepressant use was associated with a 21 percent higher risk of atrial fibrillation, the study found. This didn’t vary based on the type of antidepressants people used.
Atrial fibrillation risk didn’t appear to be influenced by anger or social ties, the study also found.
While the study wasn’t a controlled experiment designed to prove whether or how burnout or any other specific symptoms might directly cause atrial fibrillation, there are two likely explanations for the connection between exhaustion and the heart rhythm disorder, Garg says.
“Vital exhaustion is associated with increased inflammation and increased activation of the body’s physiological stress response,” Garg says. “When these two things are chronically activated that can have serious and damaging effects on the heart tissue, which could then eventually lead to the development of [atrial fibrillation].”
It’s also possible that burnout leads to unhealthy behaviors — like eating more and exercising less — that can lead to the development of risk factors for atrial fibrillation, like high blood pressure, obesity, and diabetes, Garg adds.
Long work hours may also play a role. A study published in September 2017 in the European Heart Journal followed more than 85,000 adults for a decade and found working at least 55 hours a week associated with a 42 percent higher risk of atrial fibrillation than working 35 to 40 hours a week.
“This new study adds to this evidence by showing that exhaustion is linked to the development of atrial fibrillation and that this association can be seen even during a very long follow-up,” says Mika Kivimaki, PhD, lead author of the worker study and a professor at University College London.
Ways To Reduce Negative Emotions and Maintain Heart Health
There are many ways that people can try to avoid negative emotions and lead a heart-healthy life, says Christoph Herrmann-Lingen, Prof. Dr. Med., coauthor of an editorial accompanying the study and director of the department of psychosomatic medicine and psychotherapy at the University of Göttingen Medical Centre in Germany.
For starters, people should try to minimize interpersonal conflicts, Dr. Herrmann-Lingen says. This might mean learning better strategies for conflict resolution or anger management, for example, or learning relaxation techniques to reduce stress when difficult situations can’t easily be resolved.
When possible, working less or leaving a stressful job can also help, Herrmann-Lingen advises. And so can healthy forms of stress relief, like running or yoga, instead of unhealthy alternatives, like drinking and smoking.
At the end of the day, however, it’s unclear how much we can control all of the sources of burnout that might lead to atrial fibrillation, says Tom Marshall, MBChB, PhD, of the Institute of Applied Health Research at the University of Birmingham in England.
“Clearly we would prefer to avoid negative emotions and to manage them better, but many of the reasons for negative emotions are outside of our control,” says Dr. Marshall, who wasn’t involved in the burnout study.
To minimize the risk of atrial fibrillation, people may want to do their best to avoid common risk factors for high blood pressure, like diabetes, obesity, and a diet high in salt, fat, or cholesterol, Marshall suggests.
“Hypertension is the most common modifiable risk factor for atrial fibrillation,” Marshall says.