Finding Balance

The path to a healthy heart
By C. Michael Gibson, MD

We can all relate to the feeling of stress. Something makes us nervous or scares us and our bodies respond with a faster heartbeat, sweat, and rapid breathing. This is all a product of our fight-or-flight reflex. Reacting to our environment, the brain floods the body with stress hormones such as adrenaline and cortisol, putting us on edge.

At one time, being on edge was a good thing for humans. Given all the dangers faced by hunter-gatherers, a little stress could greatly increase lifespan. Now, however, we face a lot of stress that isn’t exactly life-threatening: an unforeseen traffic jam; bad tax news from the accountant; a prickly situation at work. Fight-or-flight are clearly not acceptable options in any of these scenarios, but the brain doesn’t always know that. It’s our job to tell it to calm down.

Stress and health

There’s no question we have an overriding interest in controlling stress. Beyond the discomfort caused by simply feeling anxious, stress can have some pretty severe health consequences, such as headaches, gastrointestinal problems, and diminished heart health.

As an interventional cardiologist, this last issue is my main concern. Along with poor diet, lack of exercise, and other factors, stress is a major driver of heart disease. Perhaps most tragic, it is one of the easier causes to subdue.

Inner balance

Improving health by finding inner balance is not a new idea. Mind/body pioneers like Herb Benson and Jon Kabat-Zinn have been advocating these practices since the 1970s. However, a recent surge in scientific interest in meditation and heart health has highlighted how useful these disciplines can be.

Meditation can have a profound effect on the brain. While studying Buddhist monks during meditation, researchers have found they have amazing control over various parts of their brains, particularly the prefrontal cortex, which links rational thoughts to emotional impulses.

While inner balance on its own cannot guarantee health, it is an effective way to improve emotional balance while decreasing risk factors for heart disease. Meditation has been shown to decrease serum cortisol levels, lower heart rates, and reduce blood pressure in both healthy individuals and people suffering from heart disease.

For those who want to maintain heart health, stress reduction can help prevent hypertension, a leading cause of heart disease in the US. Those who have heart disease and are looking to manage their condition may find that inner balance can improve emotional health, making it easier to cope with the psychological burdens of chronic illness.

Helpful techniques

Two approaches in particular have been proven especially beneficial for heart health. The first is Relaxation Response, a technique developed by Herb Benson, a Harvard cardiologist and researcher. Practitioners focus on their breathing, creating a state of deep rest. They are essentially reversing the fight-or-flight reflex. Relaxation Response has been shown to lower both heart rate and blood pressure.

The other technique is Mindfulness Based Stress Reduction (MBSR), which was developed by Jon Kabat-Zinn, founder of the Center for Mindfulness in Medicine, Healthcare, and Society at the University of Massachusetts Medical School. Kabat-Zinn has been teaching MBSR at the center since 1979.

The program is similar to Benson’s Relaxation Response, but focuses on increased awareness and paying close attention to the present. The key is learning to relate to our own sensations, thoughts, and emotions. By focusing on what’s happening at any given moment, we can develop the necessary tools to deal with stress. MBSR has also been shown to benefit heart health—particu­larly reducing blood pressure—and has been used widely to improve psycho­logical well-being.

Achieving inner balance through mindfulness techniques and meditation practice is not a magic bullet. We still have to do the heavy lifting of adopting a healthy diet and consistent exercise regimen. Still, it can have significant physiological and mental health benefits and, when combined with good habits, can even help reverse heart disease.

But remember, finding inner balance is as much about lifestyle as it is about meditation. Although I do meditate and practice mindfulness, I also embrace other activities that help me create balance. For example, I tend to my Japanese garden, hunt for moss in the surrounding woods, and paint every day.

It’s also important to connect with family and friends. Many studies have shown that social isolation is bad for the heart—in other words, don’t go it alone.

Our instinctive reaction to stress is to tense up, which ultimately makes it worse. Inner balance helps us take control of the relationship between mind and body; alleviate stress; and live calmer, happier lives.


C. Michael Gibson, MD, is an inter­ventional cardiologist and chief of clinical research in the cardiovascular division at Beth Israel Deaconess Medical Center, Harvard Medical School