Spirituality and heart health might have a closer association than they appear.
Last time I had written about myths and facts surrounding alcohol consumption and cardiac health. As compared to spirituosity, it is more difficult to define the role of spirituality in cardiac health. The topic has rarely been scientifically analysed or published. This article will aim to define spirituality, explain it’s hormonal and neurological effects on the heart, discuss why it’s so difficult to design and conduct scientific studies about these effects and suggest some broad recommendations. Spirituality and meditation are being used in a very broad sense here, and do not refer to any specific type of spiritual practice.
Oxford dictionary defines spirituality as an aspirational “human quality of being concerned with the human spirit or soul (as opposed to material or physical things)”. Meditation, is one of the ways to express this desire and can be defined as a “practice that involves focusing one’s mind using a combination of various mental and physical techniques”. Even though it is possible for one to be spiritual and yet not meditate, most philosophies underline an important role of meditation in the practice of spirituality. There are various types of meditation practices. The ones which have been studied are “transcendental meditation” (TM) which involves an inward focus of the mind and “mindfulness” guided stress reduction. When the protagonist in the movie The Three Idiots keeps telling himself and his friends during times of stress that “all is well”, he might actually have been practising mindful stress reduction.
NEUROLOGICAL AND HORMONAL EFFECTS OF SPIRITUALITY
The functioning of all human systems, including cardiovascular, is regulated by an electrical (neurological) and a chemical (hormonal) controlling mechanism. Both these work in tandem, interacting closely with each other at various levels.
Autonomic nervous system (ANS) refers to the largely involuntary component of the electrical control, which regulates basic physiological functions of the body. ANS in turn has two arms – sympathetic and parasympathetic. Cardiac function is controlled by both. The excitatory sympathetic pathway leads to an increase in heart rate, blood pressure and oxygen consumption. This helps a human body in coping with stresses, commonly termed as the fear, fight and flight response. The counterregulatory and calming parasympathetic system causes a reduction of the heart rate, blood pressure and oxygen consumption. It is obvious that a normally functioning human heart needs to have the right balance of both – a high parasympathetic activity at baseline and a robust sympathetic response during periods of stress.
Spiritual practice causes an increase in baseline parasympathetic activity. This leads to a reduction in resting heart rate and blood pressure. Paradoxically this also results in a conservation of chemicals and receptors of the sympathetic nervous system, so that these individuals mount a more effective response, when needed.
Hormonally, the heart is under direct control of thyroid and adrenal glands. Chemicals from both these cause an increase in heart rate and blood pressure. TM, by reducing the steroid surge, has been documented to reduce heart rate and blood pressure. It may not be a coincidence that most spiritual practices are recommended early morning, when steroid hormone levels are at their peak!
TM also causes an increase in the four happy hormones (dopamine, endorphins, oxytocin and serotonin) inside the brain causing a further reduction in blood pressure.
DIFFICULTIES IN STUDYING CARDIAC EFFECTS OF SPIRITUALITY AND EXISTING DATA
Many factors contribute to the paucity of scientific studies on health-related effects of spirituality. These include a lack of uniform definition of spirituality; the personal and non-evaluative nature of most spiritual practices (many spiritual practitioners may not even be willing to participate in such trials); the impossibility of having animal studies on the subject and the lack of measurable end-points for effects of spirituality as many neurological and hormonal changes are local (at the cellular level) and transient.
Despite this, some studies have evaluated and found a positive impact on various cardiac functions. TM techniques have been shown to reduce both systolic and diastolic blood pressure and have a complimentary effect to drug treatment for high blood pressure. In a recently published meta analysis, spiritual practice also showed a trend towards better outcomes in patients with heart failure. This was despite the heterogeneity of the practices involved. While it is difficult to document a preventive benefit of spirituality in heart attacks, few studies have shown that post heart attack convalescence and recovery is better among spiritual practitioners. By reducing blood pressure and stress induced chemicals at a cellular level, spiritual practice tends to reduce irregular heart beating (arrythmias).
DO EFFECTS OF SPIRITUALITY AND PHYSICAL EXERCISE OPPOSE EACH OTHER?
Superficially, it might appear that physical exercise makes the heart beat faster and causes an increase in blood pressure. Spirituality on the other hand aims at the opposite. Paradoxically and in practice, regular exercisers have lower resting heart rates and blood pressure. This paradox results from a mechanism called “sympathetic—parasympathetic coupling”. A transient increase in sympathetic activity (such as during exercise) causes a prolonged increase in parasympathetic activity,
thereby resulting in a long-term reduction in heart rate and blood pressure. Hence physical exercise and spiritual practice complement each other in reducing heart rate and blood pressure.
Conclusions about spirituality and heart heath are simple. While all destressing activities might not be spiritual in nature, all spiritual exercises are almost always destressing. Scientific data about this aspect of cardiology is not only scarce but is also likely to be difficult to compile and analyse due to the above enumerated factors. Even with inadequate data, there is certainly a trend towards better outcomes in patients with elevated blood pressure, heart failure and heart attacks among practitioners of spirituality. So, in essence one should try to be as spiritual as possible, in whichever way he desires. Even if the scientifically documented benefit towards a healthy heart is meagre, there’s certainly no adverse effect of the practice.
Prof Hemant Madan is an Interventional Cardiologist and Programme Head, Cardiac Sciences for Narayana Health. He can be contacted at dr.h.madan@gmail.com