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Almost everyone has experienced stress at some point. This feeling of emotional or physical tension can stem from any event or thought that makes you feel frustrated, angry, or irritable.
But did you know that stress can also affect your body, especially your heart? Many people have experienced short-term stress, a physiological and psychological reaction to a specific event that quickly passes, such as giving a speech or slamming on the brakes to avoid an oncoming car.
Meanwhile, chronic stress, a persistent feeling of feeling pressured and overwhelmed over a long period of time, can come from a toxic work environment, for example, or being overworked, or not being able to pay the monthly bills.
“Stress is sometimes underestimated as a risk factor for heart disease,” says Rachel Lampert, a cardiologist at Yale Medicine. In fact, some experts go so far as to say that stress is a major risk factor for heart disease — the biggest killer in the United States and the world — along with unhealthy diet, lack of physical activity, smoking, excessive alcohol use, and obesity.
1. There are many ways stress can affect the heart
There are several ways in which stress can lead to heart disease. “Long-term — or chronic — stress can cause higher levels of inflammation in the body that contribute to increased plaque buildup in the arteries — and that can lead to problems like coronary artery disease,” says Dr. Lampert.
And coronary artery disease can lead to heart attacks, abnormal
heart rhythms, and heart failure. Stress also triggers an increase in catecholamines, hormones produced in the adrenal glands.
One of the catecholamines is adrenaline, the “fight or flight” hormone that increases mental alertness during stressful situations. But adrenaline also causes heart rate and blood pressure to increase. And persistently high levels can damage the heart over time.
Prolonged elevations in another stress hormone, called cortisol, also raise blood pressure, as well as blood sugar, cholesterol, and triglyceride levels.
For someone living with chronic stress, the result can be chest pain, irregular heartbeat, shortness of breath, and an increased risk of heart attack and stroke. But short-term stress can also have an impact.
“For example, in people who already have a buildup of plaque in their arteries, the surge in adrenaline can sometimes cause the plaque to break off and form a blood clot, which can grow large enough to completely block blood flow and cause a heart attack,” explains Dr. Lampert.
In people with pre-existing heart problems, such as arrhythmias (abnormal heart rhythms), sudden stress can worsen their symptoms. But stress can also have indirect effects on the heart.
“When people feel they can’t escape their chronically stressful circumstances,
they may cope by turning to unhealthy behaviors, such as unhealthy diet, smoking, and excessive alcohol use. These behaviors can lead to health problems such as high cholesterol and hypertension, which are major risk factors for heart disease,” she adds.
2. Stress affects people in different ways
When it comes to stress, everyone is different — and the same goes for heart disease. What is considered a stressor or what is stressful for one person versus another is subjective.
There is also a lot of variability in the effects of that challenge, depending on your past experiences and how you have learned to cope with the emotional effects. To that end, some people who have experienced significant stress will develop heart disease, while others will not, adds Dr. Lampert.
“This situation is similar to cancer. Among people who smoke, some do not get cancer, while others do. Why is this? It is a combination of their genetic vulnerability, environment and lifestyle - and how all of these factors work together to develop the disease,” she says.
A study recently published in the medical journal The Lancet showed that people who reported high levels of stress, a history of depression and other psychosocial factors were 2.5 times more likely to have a heart attack than those who had low stress or no history of depression.
Other research has linked stress and heart disease to groups that have experienced discrimination, including women, people from certain ethnic or racial backgrounds, and those with mental health disorders.
But the doctor clarifies that not all symptoms during stress are due to heart problems. Stress can also cause symptoms that are worrisome, such as a fast heart rate, but “that’s just how your body normally feels when you’re stressed.”
However, anyone experiencing new or recurring symptoms should talk to their doctor to understand to what extent a heart problem may — or may not — be causing that symptom.
3. Talk to your doctor about your stress level.
Anyone who is concerned about their stress levels should talk about it when they see their family doctor or a cardiologist. “I talk a lot about stress with patients. We want to know how stress from their family, work, or community has affected them. And how that might contribute to their blood pressure, their weight, and ultimately their risk of developing heart disease,” says Lambert.
In such cases, doctors recommend a number of urgent measures such as increased physical activity, yoga and other relaxation techniques; improved sleep hygiene; spending more time with others; psychotherapy; volunteering in the community.
Of course, they also recommend medication to help with ongoing symptoms of depression or anxiety. For people who already have a heart problem — perhaps even a heart attack — studies have shown that participating in a cardiac rehabilitation program results in reduced stress, as well as depression and anxiety.
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