Summary:
The heart is both the seat of life, and consciousness. The first heartbeat marks the birth of new life and when that heart stops beating is generally the end of life. Of late, many noted personalities have suffered unexpected heart attacks, leading to untimely death. Instances of heartbeats falling out of rhythm like bad music, technically called arrhythmia, often go undiagnosed. This raises a question on whether we really know our heart health everyday.
As a species, humans are constantly inundated with stressors every day and night, and the modern lifestyle with its speed, sleep and technology-connectedness have increased the stressors leading to silent problems in the heart. Our current modern life is but the blink of an eye in the evolutionary history of humans on this blue planet; from the days of cave-dwellers to agriculture to industrial to the current digital age. So our nervous system (which protected us from dangers erstwhile) is now getting constantly triggered in fight-or-flight mode which builds chronic stress withnot enough rest.
These show up suddenly as the heart keeps trying to adjust and then gives up. Finding a way to measure and improve on heart health, which seems like a blackbox of a plane is indeed possible. Improvements are guaranteed tools like breath-work and others. Heart rate variability, HRV in short, is the tool available with modern wearable technology which helps us understand the resilience of the body and the mind, against physical and mental stresses. Simple lifestyle corrections like slowing down the breath, fitness, yoga, singing, art etc can build back the broken balance. With consistent practice over a period of time, measurement with interventions can help bring our heart back to its default happy state.
Let’s de-stress the world and make the heart happy one breath at a time.
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A few days back, a story flashed in Indian social media about a young CEO of a major company who had a heart attack and died on the spot. Turned out this person had a few common connections in my social circle and people were talking about how we do not know what the real state of our own health is. This instance was clearly not a freak outlier as in the last few years many famous personalities had had a similar fate, from a famous singer on stage, to one of the best comedians in gym, to a Kannada superstar, and so on,
As I started thinking of what is causing all such heart diseases, I remembered my own personal story. I was on a trans-continental flight a year and half ago, 40,000 feet in the air ,returning from a wonderful trip in the US and Europe. I had attended a Singularity University Executive Program engrossed in future exponential tech, from space to DNA to quantum to AI and everything in between. I went to sleep thinking about how life is going to change in this exciting century, albeit with a little bit of uneasiness which I thought was due to the long travel.
Little did I know what was churning within, or in my own heart to be precise. Somewhere in the skies over the middle of the oceans I woke up feeling a little bit of heaviness in my chest. I knew instantly something was wrong as I had not felt something like this before. I thought of alerting the airline staff, but I realised around me everyone else was sleeping. I wasn’t sure if I would call someone, if I would be able to speak properly and explain my situation.
Just as I was starting to feel helpless thinking that the worst was about to happen, I remembered my recent acquisition, an Apple Watch. I checked my heart beat on it, and sure enough it was hovering in the 130s, very high considering I had just woken up from sleep. I also remembered that the watch has a ECG feature, and instinctively I clicked a few icons on my watch to start ECG. Thirty seconds later, the ECG came out as inconclusive. Now I was perplexed. I had done an ECG just before going to sleep just to try, and it had normal sinus rhythm.
Confused, I tried again, and this time the words “Atrial Fibrillation" flashed on the screen. I wasn’t sure then what it meant, but it seemed to confirm my suspicion that something was wrong. I did the ECG again just to be sure, and the same words A-Fib repeated. I started reading about it and soon realised I could be in serious danger. Various scenarios started playing in my mind, and in one I did think I would not come out of the airplane alive.
Desperate to find a way out, I remembered the first sign of this episode was high heart rate (or beating chest) and started thinking of ways to lower my heartbeat. I remembered from my childhood training in yoga, and subsequent experience of a number of Himalayan treks, that exhaling slowly is a way to reduce breathlessness when physically tired. I started making determined attempts to breathe slow, and started seeing the first improvement in heart rate. I kept doing this slowly over the next hour and half determined to get out of danger. Thankfully, two hours later, I took another ECG, and this time it came back as normal.
The training and experience in life along with the Apple watch may have averted a potential disaster. As I landed some hours later in Mumbai, I was completely normal, albeit a bit shocked, and of course very thankful to god for having saved me.
I was lucky to be out alive, but many are not. In India, 28,000 people die of heart attacks every year, a number that is almost 70% more than a decade ago. The number is a whopping 647,000 in the US, making it the largest cause of death, one every 33 seconds. These incidents seemed to have escalated especially after COVID as well, making one wonder what is going on.
So what's really going on? Over the next year I have done a lot of work understanding the core science and its applications in real life, including working on a breakthrough product that we expect to launch soon. Through this journey, I have come across bits from biology, neuroscience, spirituality, technology, engineering and behavioural psychology through books and internet as well as other forms of media. While not an expert, I am presenting here a picture of what would be useful for a layperson, to take care of the heart and thrive in life.
Our heart is both an electromechanical pump as seen from the western science, and that combined with a seat of love, compassion and consciousness as per eastern/ holistic knowledge systems. The first sign of life is the beating of the heart as a baby is born, and the last sign of life before one leaves this world is the stopping of this heart as shown by a flat lined ECG. As such, the heart is the most important organ in a way for assessing health, as it seems to capture both long-term and short-term health in a single measure adequately.
The number of beats per minute, which is defined as the heart rate (HR), is probably the single measure to understand the heart. That is why the first thing a doctor checks in a person is usually the pulse, by placing fingers on the wrist. It is also the first test doctors use in an emergency to check if a person is alive or dead. The heart beating is indeed the sign of life in many ways. The second thing that doctors in earlier times used to do, is to listen to the sounds of heart beating by placing the audio receiver on the chest through a stethoscope. This provides additional information on the waveform of the heart beats, the amplitude of the wave as well as rhythm. A heart beating out of rhythm is generally abnormal and is this is termed as arrhythmia, which is a broad all-encompassing term, and A-Fib is one of the many conditions which fall under that. At its most basic, it's like listening to leaky taps or malfunctioning valves in a bathroom filled with pipes by listening to the bathroom walls. On the other hand, a steady and low heart rate is often a sign of a super fit body.
The other important measure is Heart Rate Variability, or HRV. HRV denotes the variability of the heart rate, or the ease with which the heart can beat faster or slower depending upon the demands. In this sense HRV is the ease with which an individual can take up tasks that require more or less amount of blood to be pumped out, which is termed as cardiac output. Higher HRV denotes higher ability of the heart to perform under varying conditions.
Since we live in an environment with constantly changing external and internal conditions, our HR and HRV keeps changing. The changes are inversely proportional, in the sense that higher HR means lower HRV and vice versa. So, while lower HR is good in general for an individual, higher HRV is considered good in general. HR is determined by a combination of the nervous system that controls the electrical activity flexing the muscles of the heart, which balances the needs of the energy across the body and the brain with the oxygen carrying haemoglobin laced blood that the heat pumps.
The nervous system is generally composed of the central nervous system that includes the brain and spinal cord; and the peripheral nervous system that includes autonomic nervous system and somatic nervous system. The autonomic nervous system first one refers to the voluntary actions like walking, and the somatic one refers to the involuntary functions, like say functioning of kidneys.
The autonomic system is further subdivided into sympathetic nervous system and parasympathetic nervous system. Sympathetic nervous system refers to the response of the body for a fight-or-flight scenario or physiological or mental stress that leads to increase in heart rate. The parasympathetic refers to the rest-and-digest system, which is responsible for reduction in heart rate by calming it down or stress reducing.
To understand why there is a marked increase in the incidences of heart attacks, and in general arrhythmias, we have to understand that there are many things going on. But the most simple explanation is the increase in stress in life over a long period of time. The cumulative stress is called chronic stress which has a huge impact on the body. It's easy nowadays to see the tell-tale signs of chronic stress in so many people around us - the fatigue, the low moods, the headaches, the sleeplessness and frequent illnesses many of which are non specific till they show up as a disease. We often can see friends or family or colleagues who appear to be slowly moving toward a stress threshold, beyond which it leads to long-term burnout that can literally make one die.
This was proven first by Dr. Hans Selye, a Hungarian-Canadian Endocrinologist in rats, and he wrote that diseases didn't kill the rats, but stress did. He is also the first person to bring the word stress into medical literature in 1936, and defined it as non-specific response to the body to any demand for change. His definition of stress was the work required for any stressors, and he later referred to as good stress (eu-stress) and bad stress (di-stress) to bring out the fact that some stress is necessary and good too. He also referred to the levels of stress or general adaptation syndrome as alarm (or tension), fatigue and finally exhaustion as can be seen in graph below.
Given the broad sweep of his claims without adequate experimental proof in humans (as well as non-standard language and subsequent functions of gene theory as explanation of all life post-discovery of double helix structure of DNA), Seleyes’s theories became less and less mainstream. While originally from the discipline of physics and civil engineering as stress, the term was later taken into many other branches of knowledge such as psychology and kept on becoming popular in general culture, but without a broad measure of stress to help understand the baseline and work towards its improvement.
That missing piece is HRV.
As our body goes through typical stresses of daily life, our performance goes up with a high HRV, but at some stage of increasing stress, our systems get fatigued and exhausted leading to fall in HRV.
Before we come to a more detailed look at HRV as the missing piece for the health of the heart, let us consider various longer range and near-term changes that humans are going through which impact our biology. The longest range one can think of is genetics. In the history of human species, our current version is like a minute in the day of our species from the first human. So most of our genes came from the time we were hunter-gatherers and a few into the agricultural age, which may be the last hour on this first day.
So our nervous system still relates to the dangers in our surroundings to initiate a fight or flight response, or the sympathetic nervous system. However, we are no longer attacked by lions or tigers. But our environmental cues bring about a sympathetic response in us, increasing the heart rate.
These modern stressors can be getting stuck in traffic, or being criticised by a boss in a conference call, or inflation making daily life difficult, or parents' constant reminders being considered as yelling. The trinity of the disease, despair and death thus works through higher and higher stress. Post-Covid, the level of stress has skyrocketed, as can be seen in the latest survey where 55% Americans are stressed with many feeling paralysed by the stress, and workplace stress being experienced by 94% of coworkers. These shocking statistics as per polls conducted by American Psychology Association make one wonder whether humans have become the lab rats of Hans Selye, whose accidental death due to a change in their environment brought him to discover stress in the first place. The DSM classification )which is the authoritative guide and industry standard to definitions of psychological disorders and their descriptions uses the word stress more than 1000 times).
Why do we misunderstand the environmental changes which are not truly life threatening as that?
The answer is again that our behaviour is effectively involuntary, under the autonomic nervous system which is guided by its own learning - over the day in human species, of which only the last minute is the current highly industrialised world of the last 300 odd years. The present generation of humans are further accelerating at a dizzying change starting from landlines and mobiles into brain chips; and in a few generations from horse carts to space travellers to self-driving cars . Our lifestyles change from wholesome food to processed high-salt high-sugar foods. Our continuously declining sleep patterns going further and further away from natural circadian rhythms, due to artificial illumination all around, and continuous connectedness are making an already-difficult battle for the nervous system reach a tipping point. And that's a reason for the manifold increase in heart attacks, suicides, depression, metabolic diseases like diabetes, cancers and so on.
The human race strands on the gates of major pandemic - which unlike Covid (that originated from outside) originates from inside us, as lack of adaptation to environment.
Thankfully the solution is not hard at all. In fact, as my own experience pointed out a year ago, it's staring us in the face or more specifically in the nose.
If we were to breathe slower by exhaling slowly, that would trigger our parasympathetic nervous system, and bring in calm and growth. This brings about cardiac coherence, of which HRV is a measure. If our HRV is high, then the HRV curve shows a sinus rhythm (like mine showed once I became aware of the problem and breathed my way slowly out of it). Triggering the parasympathetic nervous system effectively brings the involuntary activities under the ambit of our control, sort of like taking back control of our wayward car which has lost its steering wheel with brakes failing. Getting back control is like the Hollywood movie Speed in which superstar Keanu Reeves saves the day for a train full of kids out for a picnic with the beautiful teacher Sandra Bullock. The outcome is not only survival, but also thriving - because at a cellular level we can only grow when we are not in danger.
Continuous danger stunts growth leading to eventual death of cells, as they can not reproduce without errors. It's like children in exam hall (under pressure) can often forget what they prepared for months. Achieving cardiac coherence with HRV biofeedback is eminently possible for every human being, from a stressed CEO, to a woman looking to become a mother or worried due to erratic cycles, to an exam-phobic college-goer; with the symphony of the next generation of wearable technology and algorithms for smart insights and assisted interventions to bring about the de-stressing one breath at a time.
Our best output as humans is when we are in an environment we perceive as safe and nourishing, sort of like the early stage of human performance graph of Hans Selye. Later in life, Selye also realised the key to crossing over to eustress lies in Gratitude. We flourish when we are nourished and we nourish all around us. From our perspective, we can define this as the trinity of Acceptance, Contentment and Transformation (ACT). ACT framework can be operationalised by increasing HRV over a period of time and can be done by a number of techniques not just restricted to breath (which was an SOS for me) but also in more constructive approaches such as fitness, to guided breath-work, to music, to mindfulness, to meditation through courses under trainers/ coaches/ gurus.
The ultimate benefit of it all (once one has mastered life or survival by becoming adept at managing changes in the external environment) is the ability to transform oneself to a higher potential, which could be discovering the truth of the highest self. In effect, this sets in stage a process of achieving independence from stressors of life, and freeing from death, and coincidentally this blog is getting published on the day India achieved independence from its colonial oppressors.
However, just as freedom was a tool for being able to achieve the true potential, becoming independent of stressors is the tool to achieve the highest potential as a human being. That will be the subject of the next blog. Subscribe to our mailing list at thebreathai.com to keep up with future blog posts!
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