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A good heart-y laugh can do wonders for heart health, say University of Maryland researchers. And conversely, people with heart disease are 40% less likely to laugh in humorous situations than those with healthy hearts, according to a paper presented at the American Heart Association’s annual meeting in New Orleans last November.
"The old saying that laughter is the best medicine definitely appears to be true when it comes to protecting your heart," says Michael Miller, MD, director of the Center for Preventive Cardiology at the University of Maryland Medical Center in Baltimore.
The study of 300 people — half of whom had histories of heart problems — used the Situational Humor Response Questionnaire to gauge how healthy people and those with heart disease differed in their responses to situations where humor was expected, says Adam Clark, MD, a cardiologist who worked with Miller on the unpublished study.
Clark says the team based its research in part on findings that people with Type A personalities are more prone to heart disease that those with a more placid nature. Particularly, says Clark, study participants were screened for the anger and hostility components of Type A.
Clark and Miller used the Minnesota Multiphasic Personality Scale to determine Type A personalities and the Cook-Medley hostility scale.
"There are probably 100 different types of humor, so it is difficult to measure sense of humor," says Clark. He says he decided to use as a control for each subject a closely affiliated person without heart disease — typically a spouse or family member — and first administered the questionnaire designed to measure sense of humor.
Here is a sample question: You are shopping alone in a city distant from your home when you unexpectedly encounter an acquaintance you haven’t seen for a long time. Rate how amusing you would find this situation on a scale of one to five, with one (not at all amusing) to five (you laugh heartily).
"People without heart disease had a higher score on the humor scale, and that correlated with less coronary artery disease," says Clark.
Clark and Miller theorize that a higher tendency toward laughter relieves anxiety and indicates lower hostility. "We know that many things happen physiologically with laughter," says Clark. "The heart rate increases, and there has even been evidence that platelet aggregation is decreased, lowering the risk of thrombosis."
Perhaps the psychological effects, and the physiological spillover, are more important, says Clark. During laughter, a tremendous amount of stress and anxiety are released. "Some of the ways we handle anxiety and use laughter are ingrained, and they may play a critical role in whether or not we develop heart disease. That may be the most important mechanism at work here," he says.
Clark also says the study suggests that people use laughter to modulate their behavior to help them through anxiety-provoking experiences. He also points out that humans are social animals and since laughter is a social activity, it "helps us feel that we aren’t alone."
"We don’t know whether people lacking a sense of humor are prone to developing heart disease or whether having heart disease tends to sour a person’s sense of humor, but I’d like to believe the former," Clark concludes.
What’s most important about the study, he says, is that this is another confirmation of the mind-body connection about which many health care professionals remain skeptical.
Researchers at the College of St. Scholastica agree that laughter may be a powerful mechanism in coping with stress and concluded that laughter may have certain health benefits.1 Using eight college-age volunteers, Tommy Boone, PhD, lead researcher and chair of the exercise physiology department at the college in Duluth, MN, measured cardiac output after subjects watched a humorous five-minute video featuring comedian Robin Williams.
They found that laughter significantly increased cardiac stroke volume and cardiac outputs. "There was a significant increase in the amount of blood ejected, and the effect was highly centralized in the thoracic area," says Boone. Blood pressure was unaffected, although other studies have indicated an increase in blood pressure during a period of laughter.
The effects of laughter continued for at least five minutes after the laughter period with the same beneficial effects.
Boone’s study also defined something laughter does not do: mimic the effects of aerobic exercise. He found that heart rates were elevated only slightly during the laughter period — to about 75 beats per minutes, as opposed to the 120 beats per minute necessary to constitute aerobic exercise.
"One thing we were able to determine immediately is that the physiological response to laughter is not the same as produced by aerobic exercise," he says.
Boone says his research is a starting place for more studies on the health benefits of laughter. "While there are several anecdotal accounts of healing through laughter, the prevention of health problems using laughter is a relatively new area of research and merits deeper examination."
1. Boone T, Hansen S, Erlandson A. Cardiovascular responses to laughter: A pilot project. Appl Nurs Res 2000; 13:204-208.