High on a Himalayan peak, just below 20,000 feet, Conrad Anker felt an unusual sensation: he was tired.
For a typical 53-year-old, this would not have been surprising. Anker, an acclaimed mountaineer, had been climbing for seven hours since 2 a.m. and was on his sixth rope-supported section on the way to the 22,621-foot summit of an unconquered peak called Lunag-Ri. That's enough to whip anyone. But Anker was not just anyone. He was in remarkable physical shape for a man of any age. Four years earlier, he had become one of just a handful of people to summit Everest without supplemental oxygen. The man was indefatigable.
But on this day he stopped climbing and sat down. He thought it could've been altitude sickness. Then it hit him—hard. It was much more than the altitude. "I just couldn't go on," he says. "I was stopped in my tracks."
He turned to his climbing partner, David Lama. "David," he said, "this is not good."
As an athlete, Anker was acutely aware of the state of his heart. "I can feel it when I'm climbing, but also when I'm sleeping or resting." Just a few months earlier he'd undergone a battery of tests as he trekked Kilimanjaro, a 19,341-foot summit. Everything had checked out perfectly, so this sensation disturbed him. "It was like a severe muscle pain in my heart," he says.
He and Lama turned back to the advance base camp thousands of feet below, rappelling down the mountain almost by instinct. When they arrived, Anker began to feel better and decided to tough it out. "I said, 'Yeah, I got this, I'm just going to heal up.' "
Instead, the 26-year-old Lama made the snap decision to call for assistance. A helicopter happened to be in the area and transported Anker to a Kathmandu hospital, where doctors discovered the problem: Anker had experienced an acute thrombotic occlusion of his anterior descending coronary artery—or, in layman's terms, a sudden heart attack.
The culprit was a piece of fatty plaque blocking one of the main blood vessels to his heart. The piece was small—the size of a crumb. Nine hours after he first felt his chest tighten, doctors inserted a stent in the offending vessel. "If there was ever a time to call in my chips, that was it," he says. "Luckily it worked out, every step of the way."
Every year in the United States, about 735,000 people have heart attacks. Few are world-class athletes like Anker. His episode could have been caused by random chance, bad genetic luck, or perhaps a lifetime of extreme demands on his most important organ. But Anker pinpointed another possible cause: grief.
Five months earlier, Anker had trekked up Tibet's 26,335-foot Shisha Pangma with a different team. This time the mission was somber: They were going to retrieve the body of his best friend, Alex Lowe, who had died in an avalanche in 1999. Anker had been with Lowe on that expedition and witnessed his friend being swept to his death. The two had been so close that Anker later married Lowe's widow, Jenni, and raised Lowe's three sons as his own. On this recent trip, Anker carried his friend's body down the mountain himself, a wrenching burden that weighed on his soul.
"Going back up there and seeing everything was super emotional," he told an interviewer from National Geographic. "I was stressed, and I felt my heart."
I felt my heart. What man hasn't at some point in his life? When we go on a first date, take a knee to propose, approach the lectern to make a speech in public, or hear of a loved one's death, our hearts talk to us. And we talk back. This is why for centuries, before we even understood how it does its primary job of pumping blood, the heart has been a powerful symbol of many things: love, emotion, intuition, conviction ("I believe in my heart"), and truth ("the heart of the matter").
Our hearts occupy the center of our emotional lives. As the 17th-century British physician William Harvey noted, "Every affection of the mind that is attended with either pain or pleasure, hope or fear, is the cause of an agitation whose influence extends to the heart."
New research across a range of disciplines suggests that these ancient myths may in fact have some validity. Studies show that our emotions can directly affect our heart health, often in tangible, physical ways. That may be why, for example, more people seem to have heart attacks on Mondays than any other day of the week; cold Mondays are even more dangerous. People who have experienced a sudden, acute trauma, such as the death of someone close, can suffer a physical change in the heart. When Anker said his friend's death touched his heart, it probably did.
Your heart is an amazing organ. It's busy enough with its main job—pumping blood—but it can also act as a bellwether of the state of your health, your level of fatigue, the role of stress in your life (and, importantly for men, anger), and yes, the state of your relationships. It keeps you alive, but it can also kill you unless you learn to understand it and listen to it.
"We know that the heart is not just a simple pump," says Mimi Guarneri, M.D., an integrative cardiologist in La Jolla, California. "There's a physical heart and there's an emotional heart, which responds to the world around you. There's also a spiritual heart, which I believe is where the seat of the soul is located, holding the truth about why you came into this world and what you came here to do as a human being."
Most men are familiar with classic risk factors like blood pressure and cholesterol, but they tend to miss the mental, emotional, and even spiritual issues that relate to the heart, Dr. Guarneri says. That's a tragedy, because understanding the human body's most miraculous organ can improve and even save your life. Here are all the jobs your heart performs and how to keep it working to perfection.
It Pumps
"The heart is the only organ of the body that is in continuous motion," says Stanford cardiologist Euan Ashley, M.D., Ph.D.
About 70 times a minute, 100,000 times a day, the four chambers of the heart expand and contract in perfect sync to send the equivalent of 2,000 gallons of oxygen-rich blood throughout your body every day. Your heart delivers blood to even the most remote parts, from your brain to your quadriceps to (when needed) the erectile tissue of your penis—and most important, to the heart muscle itself, which uses some of the blood it pumps.
Despite this wear and tear, it lasts: The walls of the heart flex and stretch and its valves keep blood flowing in the right direction without breaking down or stopping, even while you sleep. What machine could do that for 80 years?
KEEP THE BEAT
Men who exercise regularly pump more blood with each heartbeat than those who are less active, according to U.K. research. The American Heart Association recommends either five 30-minute sessions of moderate exercise or three 25-minute sessions of vigorous exercise each week, plus moderate- to high-intensity strength activities at least two days a week.
Interval training—ramping up the intensity for several minutes multiple times during your workout—is excellent. It helps train the heart and your muscles to work harder by enabling enhanced oxygen delivery and increasing muscle efficiency, says David Wolinsky, M.D., section head of nuclear cardiology at Cleveland Clinic Florida. High-intensity interval training is like pressing on the gas and going into seventh gear—the faster you go, the more efficiently your heart starts working. For eight great HIIT workouts you can do at home, check out MetaShred Extreme from Men's Health.
"Weight training, core exercise, and flexibility training are also important," says Dr. Wolinsky.
It Self-Adjusts
Your heart rate is constantly changing, even beat to beat. That's because the heart is governed by two competing halves of your autonomic nervous system, says Reginald Ho, M.D., of Thomas Jefferson School of Medicine in Philadelphia. Your sympathetic nervous system responds to threats with the fight-or-flight response, which speeds up the beat. Your calmer parasympathetic nervous system slows things down so you can rest and digest.
The two are engaged in a constant tug-of-war, says Dr. Ho, depending on external stimuli—and, crucially, your interpretation of those stimuli. A higher sympathetic "tone" means a more frantic heartbeat, higher blood pressure, and a greater risk of cardiac events. But when the parasympathetic nervous system is dominant, as it is in athletes, the rate settles down and becomes more variable.
This heart rate variability is actually a marker of good health, says Dr. Ho. Less heart rate variability, by contrast, could indicate the presence of a chronic disease or, in an athlete, overtraining. In one study of middle-aged couples, greater heart rate variability was even associated with a happier marriage.
KEEP THE BEAT
Apps such as Elite HRV and Omegawave (both free) can help you monitor your heart rate variability. First you'll establish a baseline. Then you can check daily fluctuations so you know when to work out harder and when to back off, says Alexander Koch, Ph.D., C.S.C.S., a professor of exercise science at Lenoir-Rhyne University.
It's Wired
When he was in medical school, Dr. Ashley was captivated by a unique property of the heart: "If you remove it from the body and keep it supplied with energy and oxygen, it will continue beating on its own," he says. That's because the organ has its own electrical system, with special cells that generate and dispense regular, rhythmic electrical pulses, stimulating the upper (atrial) and lower (ventricular) chambers of the heart to contract and relax. If some of those cells conk out, others can take over.
But that electrical system is also vulnerable: Problems with the complex nerves and trigger cells that control heartbeat can go awry, leading to rhythm disturbances such as atrial fibrillation, a condition affecting an estimated 2.7 to 6.1 million people in the United States. Even worse is ventricular fibrillation, when the signal becomes chaotic and the functional heart contractions simply stop.
"When that happens, more than 90 percent of the time the result is death," says Jeffrey Ardell, Ph.D., director of the Neurocardiology Center for Excellence at UCLA. Fortunately, scientists are developing electrical therapies, such as vagus nerve stimulation, to calm an erratic heart and reduce the prevalence of atrial fibrillation.
KEEP THE BEAT
To reduce your odds of AFib, lay off the sauce. The Journal of the American College of Cardiology reports that men who drink alcohol daily have a higher risk of atrial fibrillation—40 percent higher if they have five drinks a day. Excessive alcohol consumption might temporarily slow certain heart signals, throwing the whole system out of whack.
It Has a Brain
The heart has its own neurons that are clustered into nerve structures called ganglia, almost like a rudimentary brain. "When you transplant a heart, the little brain goes along with it," says Ardell. This "brain" can't form thoughts and memories, but its job is critical: It ensures that your heart's electrical and mechanical functions work in tandem to pump blood.
These ganglia respond to signals from many sources—your heart chambers, your circulatory system, your muscles, and your brain. Different types of neurons sense the mechanical and fluid demands on the heart and adjust its motion accordingly, millisecond by millisecond. Such control allows your body to deal with the everyday demands you place on it, from sleeping to standing to exercising. But it's a two-way street: The heart can talk to the brain too.
"In some cases we feel things in our heart first, and then the brain reacts," says Dr. Guarneri.
KEEP THE BEAT
To take advantage of this symbiotic relationship, tame your mind via your heart: Do daily calm-down breathing sessions of five to 10 minutes, says Dr. Guarneri. Inhale deeply on a count of four, then exhale for a count of seven. "You'll put your nervous system into a state of relaxation," she says. That calms your mind and soothes your heart.
It Listens
Your heart is more than purely mechanical: Its "brain" responds to the world around you and appears to be sensitive to music. Peter Sleight, M.D., a retired Oxford University researcher, has studied the effect of music on cardiac rhythms; he and his colleagues discovered that blood pressure and heart rate rise and fall to match the volume and pace of music. Other research reveals that rhythmic chanting (like in a yoga class) or reciting prayers has a similar calming effect.
In any case, the magic number is 10: Musical phrases or chants (or deep breaths) lasting about 10 seconds seem to sync with the Meyer wave, which is the natural ebb and flow of heart rate and blood pressure. Dr. Sleight found that some of Verdi's compositions hit this 10-beat rhythm, as does "Ave Maria."
KEEP THE BEAT
After a stressful day, listening to classical or mellow music can help lower your blood pressure. A study review published last year suggests that if you are hypertensive, listening to music could drop your systolic BP by 7 points. Focusing on your breathing can enhance the benefit, because measured breathing tends to bring down blood pressure.
It Connects
Does love really reside in the heart? Your heart flutters when you see your beloved, thanks to adrenaline. But some evidence suggests that the heart is also in on the action.
In 2012, UC Davis psychologist Emilio Ferrer, Ph.D., performed a novel experiment: He took 32 male-female couples and sat each couple alone in a room, hooked up to an EKG and a machine to measure respiration. He and his team had them perform three tasks for five minutes each: doing nothing (as a baseline), gazing at each other, and trying to imitate each other without touching or speaking. During each task, he discovered that the partners' heart rates became synchronized, beat to beat.
That result was interesting, but so was what happened next: He had each partner keep an "emotional journal" for 90 days. There, too, the partners tracked each other's ups and downs—but in most cases, it was the women who shifted their emotions and heart rates to match those of their male partners.
"Women who were changing their daily emotions as a function of their male partners' emotions were also changing their physiological signals," he says. "That wasn't the case with the men."
KEEP THE BEAT
Pay more attention to your mate's emotional and physical state, so she's not always adapting to you. The study took place in a lab, but you can try it at home, spending five minutes sitting quietly in close proximity to each other, not talking or touching.
It Breaks
The broken heart may actually be a thing, research suggests. Scientists have long observed that people who suffer sudden, severe trauma sometimes exhibit physical wounds on their pericardium (the outer layer of heart muscle) caused by extreme levels of stress neurotransmitters called catecholamines. But there's also something called takotsubo cardiomyopathy, where the left ventricle becomes temporarily deformed and weakened because of emotional stress. (Researchers decided that it looked like a takotsubo, a type of pot used in Japan to trap octopuses.) It's been observed mostly in older women who suffered emotional trauma, such as the sudden death of a relative. But men are also at risk from another set of emotions: anger.
Studies find that men who control their anger are at less cardiac risk than those who blow up easily, says Karen Matthews, Ph.D., a professor of psychiatry at the University of Pittsburgh.
"One of the things that does stand out for men is how they handle their anger," she says. "What seems to be worse for men is angry outbursts." An angry outburst increases your risk of heart attack in the following hour by two and a half times, according to research from Canada.
KEEP THE BEAT
If you feel like you're about to blow, meditate instead. In a University of Kansas study, people who meditated for 20 minutes reduced their anger and their BP. Men who meditate regularly are calmer, but even first-timers feel more peaceful after meditating, and their bodies don't act as if they're angry. Meditation tamps down the autonomic nervous system, creating soothing benefits.
It Recovers
The heart is a uniquely durable organ because it has to be. It not only outlasts any machine or battery ever invented but also seems to have the ability to heal and protect itself. Because heart cells don't divide and reproduce after infancy, they are less susceptible to developing tumors. And when bloodflow to the heart becomes restricted—as Anker's did—the heart can still beat.
"My doctor said I had basically preselected myself to survive this," he says. "By being fit and having spent so much time at altitude, my heart understood the duress it was under, and other parts [of the muscle] were able to take over."
Research from Germany suggests that people who exercise regularly may heal faster after a heart attack than those who don't—in part because working out reduces heart attack-induced scarring, thinning, and inflammation. That was the case for Anker: Two months after the incident, his ejection fraction—a measure of pumping efficiency—had recovered to 54 percent, which is within the normal range. (It had been in the low 20s after his heart attack.) And his heart muscle had no permanent damage.
KEEP THE BEAT
Some studies suggest that incorporating mindfulness into your life can reduce the risk of a secondary event, while a larger body of research links stress and anger to increased risk. Anker has been tracking his heart rate with a Fitbit, trying to avoid situations and stimuli that cause stress and quicken his heartbeat.
"I saw something in the news the other day that spiked it up to 128," he says. "So last Tuesday I took a day off from media, and just cleaned up around the house, and it was great."
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