How does stress affect my heart?

Eric Olsen
The increased cardiovascular tone (increased heart rate, breathing, and blood supply to the working muscles and brain) that prepares us to run or fight is a highly adaptive and beneficial response to immediate threats. But when sustained over long periods of time, this same adaptation may result in the disease of hypertension and all the ailments associated with it. Stress also may increase platelet stickiness, and the risk of heart attack increases when platelets accumulate at the site of atherosclerotic plaque in the arteries.
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The American Journal of Medicine published an article by Dr. Vincent Figueredo titled 'The Time Has Come for Physicians to Take Notice: The Impact of Psychosocial Stressors on the Heart." Dr. Figueredo details the numerous studies that consistently show that unmanaged stress is bad for your heart. Here’s a sampling of the findings in this article:
  • Moderate to severe general stress is associated with a 65%
           increased risk for having a heart attack.
  • Chronic work stress increases risk for heart disease by 68%.
  • A lifetime of high anxiety response to stress increases your risk for
           developing heart disease. The Harvard Mastery of Stress Study
           showed that people who experienced heart attacks in middle
           age were twice as likely to have experienced severe anxiety
           when they participated in an experimental stress-provoking
           math test as college students 35 years earlier.
  • High-quality marriages reduce your risk of heart disease.
Stress appears to be a risk factor for heart disease, despite the fact that researchers don’t know exactly how. This is partly because it’s hard to measure stress and people react differently to it. But it is also because it is not easy to determine whether stress is a risk factor itself for heart disease, or if it negatively affects other risk factors for heart disease, such as blood pressure, cholesterol, or lifestyle behaviors.
Even though we don’t know exactly how, the fact remains: research has shown stress increases your heart disease risk in these ways:
  • The more stress you endure, the higher your risk of having a heart attack and dying suddenly from a heart event. 
  • Stress can cause angina (chest pain) due to an increase in heart rate and blood pressure, which increases demand on the heart.
  • Stress can damage the lining of artery walls (endothelium), increase cholesterol deposits to the artery wall, promote blood clotting, and release growth factors, all of which can lead to clogging of the arteries (atherosclerosis). 
  • Stress can increase blood sugar levels if you have diabetes, which increases your risk of heart disease and other preventable complications relating to diabetes, including eye, kidney, or nerve damage.
  • Sudden, severe stress (such as a medical diagnosis or loss of a loved one) can temporarily cause a serious, although usually temporary, dysfunction of your heart that mimics a heart attack. This condition is known as Broken Heart Syndrome or stress-induced cardiomyopathy.
Dr. Kathleen Hall
Preventive Medicine
Research from Thomas Pickering, M.D., cardiologist at Cornell Medical Center, shows that stress causes the release of epinephrine (a stress hormone) from the adrenal glands into the blood. Epinephrine triggers blood platelets, the cells responsible for repairing blood vessels, to secrete large quantities of adenosine triphosphate (ATP), a high-energy phosphate molecule required to provide energy for the body. ATP causes the blood vessels to rapidly narrow, cutting off blood flow, triggering a heart attack or stroke.
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Anthony L. Komaroff, MD
Internal Medicine
Your body reacts to life-threatening stress ("The house is on fire!") with what is commonly called the fight-or-flight response. The brain triggers a cascade of chemicals and hormones that speed the heart rate, quicken breathing, increase blood pressure, and boost the amount of energy (sugar) supplied to muscles. All of these changes enable your body to respond to an impending threat. Unfortunately, the body does a poor job of discriminating between grave, imminent dangers and less momentous, ongoing sources of stress. When the fight-or-flight response is chronically in the "on" position, the body suffers. This chronic stress response can occur if your body is persistently exposed to stressors that overwhelm its adaptive ability. Think of it as your body in a constant state of "short-circuiting."

The release of stress hormones also activates the blood's clotting system. And long-term mental stress appears to stimulate the body's production of LDL and triglycerides, to interfere with blood pressure regulation, and to activate molecules that fuel inflammation.
Dr. Michael Roizen, MD
Internal Medicine
Stress is the greatest ager of your body in general, especially the nagging, unfinished-tasks kind of stress that hangs over you day after day, or the stress of things that are out of your control (as opposed to the acute stresses-having a flat tire or adjusting to a traffic jam when you are in a hurry-that eventually get fixed).

We don't fully understand the mechanism of how emotional stress produces physical stress, but we know it is a powerful connection: In the United States for the 30 days after 9/11 (compared to the 30 days before), heart attacks increased about threefold in Washington, D.C., and New York-and even threefold in Missouri, Chicago, Kansas City and Alabama. Three major life events or sets of unfinished tasks can make you more than 32 years older in RealAge.

Just as chronic stress can damage your heart, actively working at reducing stress will keep your heart healthier. Therapies like meditation and relaxation techniques can teach you how to tolerate the stressful elements in your life-the tough boss, the rebellious teenage daughter, the dog hair on your suit-and how to tone down your body's physical response to stress (the racing heart, the stress hormones). Some people also find great stress relief in social contact, religious devotion or involvement, even playing with a pet. Find whatever refocuses your attention, and give time to it. The most consistent stress reducers that also help with depression and anger are exercise, meditation, and nurturing friendships.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.