Most people have experienced stress at some point in their lives. Stress is a feeling of physical or emotional tightness that can be brought on by any thinking or circumstance that causes you to become agitated, anxious, or furious. However, did you know that stress can cause physical discomfort, particularly to your heart.
Many people, throughout their lives, have experienced severe (or short-term) stress, a physical and mental reaction to a precise event that goes away swiftly, such as giving a speech (if you are anxious about public speaking), hitting the brakes abruptly to evade an oncoming car, or having a fight with your partner. Chronic stress, however, is a steady sense of feeling stressed and overwhelmed over a long time—it could result from a contaminated work environment, for example, caregiving, or being incapable of paying your bills.
Stress is occasionally underrecognized as a risk factor for heart disease, says Rachel Lampert, MD, a Yale Medicine cardiologist.
Some experts say that stress is a principal risk factor for heart illness—the main killer in the United States—up there with unhealthy diet, physical laziness, smoking, extreme alcohol use, and obesity.
Dr. Lampert; Yale Medicine cardiologist, Erica Spatz, MD, director of the Yale Medicine Preventive Cardiovascular Health Program; and Allison Gaffey, PhD, a Yale Medicine psychologist who specializes in cardiology—all of whom have specific interests in the impact of stress on the heart, both clinically and in their study.
There are numerous pathways through which stress can result to heart disease. “Long-term—or chronic—stress can cause complex levels of inflammation in the body that adds to upsurges in plaque accumulation in the arteries—and that can lead to such difficulties as coronary artery disease, says Dr. Lampert. Coronary artery disease can result in heart attack, irregular heart rhythms, and heart failure.
Similarly, stress drives a surge in catecholamines, hormones created in the adrenal glands. One catecholamine is adrenaline, the “fight or flight” hormone, which increases mental awareness during stressful circumstances. But adrenaline also causes the heart to beat faster and increases blood pressure. Too much, over time, can ultimately damage the heart. Prolonged elevations of additional stress hormone, called cortisol, also raise blood pressure, as well as blood sugar, cholesterol, and triglycerides.
For an individual living with chronic stress, the consequence can be chest pain, irregular heartbeats, shortness of breath, and an amplified risk of heart attack and stroke.
Short-term stress can have an influence as well. For example, in people who previously have an accumulation of plaque in their arteries, the rush of adrenaline can sometimes contribute to a plaque rupturing, resulting in a blood clot that could increase enough to block blood flow entirely and cause a heart attack, Dr. Lampert says.
In individuals with pre-existing heart difficulties, such as arrhythmias (abnormal heart rhythms), unexpected stress can aggravate their symptoms, Dr. Lampert adds.
But stress can also have secondary effects on the heart. When individuals feel they cannot escape the circumstances of their chronic stress, they may manage by resorting to unhealthy activities, says Gaffey. We know that stress is related to behaviors such as unhealthy diet, smoking, and amplified use of alcohol. These actions can lead to such health problems as high cholesterol and hypertension, which are the main risk factors for heart disease, she adds.
When it comes to stress, everyone is dissimilar—and the same is true with heart disease, Gaffey explains. What is considered to be a stressor or what is worrying for one individual versus another is subjective—there’s also a lot of inconsistency in the effects of that encounter, depending on your former experiences and how you have managed to cope with the emotional effects, she says.
To that end, some individuals who have experienced substantial stress will develop heart disease, while others won’t, adds Dr. Lampert. This is comparable to cancer, she says. Among people who smoke, some do not get cancer, and others do. Why is that? It is a mixture of their genetic weakness, environment, and lifestyle—and how all those influences work together in the growth of disease.”
A study in The Lancet presented that people who reported high stress, a history of depression, and further psychosocial factors were 2.5 times more likely to encounter a heart attack than those who had low stress or no history of depression, Gaffey says. Other studies have related stress and heart disease in groups that have experienced judgment, including women, individuals from specific ethnic or racial backgrounds, and those with mental health illnesses.
Not all signs during stress are due to heart problems, Dr. Lampert adds. Stress can also cause indications, such as a racing heart, that are just how your body generally feels when you’re overwhelmed. Most significantly, anyone undergoing new or regular symptoms should talk to their doctor to find out to what extent a heart issue might—or might not—be instigating the symptom, she says.
Anyone troubled about their stress levels should talk about it when they visit their main care provider or, if they have one, their cardiologist. I talk a lot about stress with patients, says Dr. Spatz. We want to distinguish how stress from their family, job, or community has affected them. And how that may be contributing to their blood pressure, their weight, and, eventually, their risk of developing heart disease.
During these schedules, it’s vital to raise the issue of stress since a provider may not constantly ask you about your current life conditions, stressors, or stress level, Gaffey says. But they can share supportive references, resources, and tools to help individuals better control their stress. Those might comprise of improved physical activity, yoga, and other relaxation practices; enhancements to sleep hygiene; spending time with others; psychotherapy; social work resources or assistance with health care access; and even medication to help with continuing symptoms of depression or anxiety.
The type of stress reduction that works best is diverse, Dr. Lampert adds. Some individuals find meditation or yoga helps; others may favor a walk in the woods or a run. It’s whatever works to keep your stress levels in check, she says.
