A new study of over 17,000 Israelis has found that long-term exposure to the threat of terrorism can elevate people’s resting heart rates and increase their risk of dying.
This is the first statistics-based study, and the largest of its kind, which indicates that fear induced by consistent exposure to the threat of terror can lead to negative health consequences and increase the risk of mortality.
It is well-documented that international terror outbreaks involve mass psychological trauma, leading to long-term mental health risks to the exposed population. Previous studies have also shown that in the short term, sudden stressful situations such as earthquakes can increase a person’s heart rate and their risk of having a heart attack.
However, whether long-term exposure to the threat of terror can lead to physical health risks in the exposed population has until now remained unknown.
Researchers from the Hebrew University of Jerusalem examined the factors affecting basal (resting) heart rates, and studied how these rates changed over the years during annual checkups of healthy Israeli subjects. Israel has been exposed to the repeated stress of multiple wars and terror attacks for over 60 years, with a major impact on the entire society.
The research used a study of 17,300 healthy subjects who underwent an annual general medical exam including blood tests, heart rate and stress tests at the Tel Aviv Medical Center each year.
The 10,972 men and 6,408 women in the study were apparently healthy employees attending periodic routine health examinations during the years 2002–2013.
The questionnaire covered a wide range of occupational, psychological, and physical factors, including body mass index, blood pressure, fitness, smoking, psychological well-being, anxiety, and fear of terror.
“We wanted to test whether fear of terrorism can predict an increase in pulse rate and increased risk of death,” explains Prof. Hermona Soreq, who conducted the research,
The research was conducted by Prof. Hermona Soreq, who conducted the research.
By combining the medical exam data with the questionnaire responses, the researchers found that basal heart rate was affected by physiological characteristics, such as level of physical fitness and inflammation index reflecting the activity of the immune system.
In contrast, an ongoing increase in heart rate was also influenced by psychological characteristics such as fear of terrorism. Through a statistical analysis of 325 different parameters, the researchers found that fear of terror was a major contributor to annual increases in resting heart rate, with 4.1% of study participants suffering from an elevated fear of terror that predicted an increase in their resting heart rates.
While a heartbeat of 60 beat per minute is normal, an increase of up to 70-80 beats per minute was observed in subjects who exhibited an increased fear of terrorism. In other words, for people with an elevated fear of terror, the heart beats faster and the associated risk of heart disease is higher.
Elevated resting heart rate is a predictor of death from cardiovascular disease and death across all causes. As people age, the resting heart rate typically decreases from year to year, and people whose heart rate actually increases annually are more susceptible than others to heart attacks and strokes.
The researchers also examined how the brain alerts the body to the expectation of danger. They administered a blood test to examine the function of acetylcholine, a neurotransmitter involved in responses to stress and which acts as a brake to the inflammatory response.
The results showed that the fear of terror leads to a decline in the function of acetylcholine, and thus reduces the body’s ability to defend itself from a heart attack, leading to a greater chance of dying.