How does emotional stress increase my risk of coronary heart disease?

Douglas S. Denham, DO
Family Medicine
It is generally agreed that stress, especially when chronic, can contribute to coronary artery disease. While the exact mechanisms are not precisely understood, it is known that stress can cause damage to the lining of blood vessels. This damage can lead to the development of atherosclerosis, thick plaques of cholesterol that can eventually rupture. Significant damage to the lining of blood vessels can also cause blood clots and result in death due to the tissues being deprived of blood flow. 

For a more detailed discussion of this topic, I recommend reading "How stress causes heart disease" at
Furqan H. Tejani, MD
Cardiology (Cardiovascular Disease)
In addition to coronary artery disease there is an entity known as Broken Heart Syndrome. In this disease due to an major emotional trauma, a person may have a substantial loss of his or her heart function. The good thing about this illness which has been described as Takatsubo cardiomyopathy is that after the stressful event has been withdrawn the function of the heart returns back to normal
Anthony L. Komaroff, MD
Internal Medicine
The links between the heart and the mind are harder to measure than those between the heart and the waistline. But a growing body of evidence suggests that psychological factors are -- literally -- heartfelt, and can contribute to cardiac risk. Stress from all sorts of challenging situations and events plays a significant role in cardiovascular symptoms and outcomes, particularly heart attack risk. The same is true for depression, anxiety, anger, and hostility, as well for social isolation. Acting alone, each of these factors heightens your chances of developing heart problems. But emotional issues are often intertwined: people who have one commonly have another. For example, psychological stress often leads to anxiety, depression can lead to social isolation, and so on. When combined, their influence is compounded.
Farhad Rafii, MD
Cardiology (Cardiovascular Disease)
If you think back a few thousand years when humans were hunters and gatherers, stress was a reaction that helped them to run away from saber-tooth tigers or survive hunger for days. In the modern world, stress is mainly caused by our interpersonal relationships. And, one of the largest forms of stress is loss of a loved one, divorce or a major life event. Stress is associated with increased blood pressure, anxiety, fear, desperation, helplessness and other feelings that can create an increase in stress hormones. In the older days, stress hormones were beneficial in allowing a person to run faster from danger. Nowadays, the release of stress hormones on a long-term basis can actually create injury to blood vessels and trigger a heart attack.
Emotional stress causes the release of adrenaline initially. Adrenaline has a direct stimulant effect on the heart. In addition, it can cause higher blood pressure. It also allows higher blood glucose that can complicate things. 

Chronic stress causes other hormones to be released, such as cortisol. These hormones can also lead to increased cholesterol, increased plaque in the arteries, and increased blood sugar. All of these changes combine to increase the risk of coronary artery disease.
Mary A. McLaughlin, MD
Cardiology (Cardiovascular Disease)
Stress is relative when it comes to heart disease risk, says Mary Ann McLaughlin, MD, medical director of the Cardiac Health Program at The Mount Sinai Medical Center. In this video, she explains how stress can increase your heart disease risk.

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