There is not much scientific evidence to prove that tension and emotional stress alone can cause a coronary heart attack.Yes, stress does take a nasty toll on your body but once you add stress to high cholesterol you have a recipe for a heart attack.

If your coronary arteries were clear of plaque, you could probably live under the worst kind of duress and tension— and you may not suffer a coronary attack.

Unfortunately, however, Americans don’t fall into that class. We keep busy walling-up our arteries with cholesterol and fat. So, we have to concern ourselves with tension; as a contributing cause—the trigger that sets off a coronary attack.

When some prominent person is killed by a coronary attack, newspaper writers often explain the tragedy by intimating that the deceased was an unfortunate victim of tension and overwork.

Almost everyone sincerely believes that tension is a primary cause of coronary disease. But even if a reporter knew the truth, could he boldly state that Senator So-and-so had been eating too much meat, cheese, and ice cream, or drinking too much milk? Could he report that the Senator spent too much time sitting on his Senate seat, and didn’t get enough exercise? It will be many a long day before you read a newspaper article like that.

People, generally, don’t have the right perspective on the tension side of the coronary story for several good reasons. If you go only by what you read in the newspapers, or hear on radio and TV, you would have to come to the conclusion that coronary disease hits mainly those who are making their mark in the world.

The Tom Smiths and John Joneses don’t make the headlines when they have a coronary attack. The big politicians, the tycoons, and the socialites do. Despite all this, you can be absolutely sure that probably not more than two out of every hundred Americans who suffered an attack yesterday, or any day, were rich or prominent, or anything other than the everyday run of citizen. The overwhelming majority of coronary victims are not working any harder, or living under any more tension, than any average citizen of the United States.

Let’s not take it for granted that we are the only people in the world who live under tension. The lowliest member of any aboriginal tribe has his tensions and problems— his share of fear and worry. There are endless tribal taboos and the possible wrath of many gods, the enmity of a neighboring tribe, or problems of food, shelter, and storms. Wherever there is life, there is tension.

Certainly the people of Germany, Norway, Finland, or any of the strife-torn countries were under great emotional stress during two World Wars. Why, if tension is a primary factor in producing coronary disease, should their coronary death rates have been reduced so dramatically when they were forced, by circumstances, to live on a diet that was low in fats?

In Madrid, or Naples, or Gautemala City, the death rates from coronary disease are very much higher among the people who “have money.” In fact, every “economic” survey ever made has shown that the well-to-do in any city or nation are more subject to coronary disease than the poor! Are we to assume that strain and tension are exclusive crosses of all well-to-do, while the poor bear no such burden? Ridiculous! The rich can buy richer foods. It’s just as simple as that!

Is the Italian any less excitable than the average American? Why, then, do the Italians have only one-fourth of our coronary death rate? Are the white-collar workers of Japan—much more than their American counterparts—so free from worry and tension, or the problems that make up everyday life? Is that the reason their coronary death rate is less than one-fourth of ours?

For years now, almost everyone who survived a coronary attack has been told to “take it easy.” It is a convenient and ready rule for the doctor to lay down; but the victim and his family are apt to read in meanings which just aren’t there. The victim’s wife confides, “John has been doing too much . . . working too hard. That’s why he had a coronary attack.” The truth is, of course, that John could not have been stricken if his coronary arteries had not been partially filled with cholesterol and fat. Whatever part the tension played was secondary to that fact!

Yet, the tension excuse is always going to be with us, as long as human nature exists. By citing it, every coronary patient can regard himself as a martyr. The demons of tensions and overwork struck him down. He was just a good Joe, working day and night for his family, his service-club projects, and his church.

The coronary hit him because h gave too much of himself. Trying to send his two kids through school. Trying to be a good citizen and still make ends meet. Isn’t it much more comforting to blame tension, than to admit that we paid no attention to common food-facts, or that we didn’t have the will power to avoid eating too much hard fat? Let’s put tension in its rightful place—as a contributor that triggers a coronary attack when the coronary blood vessels have already been narrowed to the danger point by plaques.

Some three years ago, we had the first acceptable experimental evidence that mental and emotional stresses can and do raise the amount of cholesterol in the blood. The following year, more proof came from Col. Marshall E. Groover, Air Force heart specialist. He found that Air Force executives who were keeping their blood cholesterol at safe levels with exercise and diet, showed a definite rise in the fat and cholesterol content of the blood when they worked under stress and tension.

Early in 1958, studies made at the College of Medical Evangelists indicated that there was a significant increase in blood cholesterol among healthy male medical students during the week they wrote their examinations. The average age of these young men was twenty-five.

One individual’s cholesterol level almost doubled during his two-day examination period.this aspect of the stress story in a different way. They studied a large group of young men, aged 25 to 40, who already had diag-nosable hardening and narrowing of the coronary arteries.

They found that over 90 percent had been working intensely for long hours, over varying periods before they experienced the attack. One-fourth of the patients held two jobs, and another 46 percent worked at least sixty hours a week. So tension can temporarily raise the cholesterol level of the blood, and become a menace in certain cases.

If you find yourself under unusual stress or prolonged stress be sure to let your doctor know.