Stress and Heart Disease

Though the evidence is not definitive, a lot of research suggests a possible link between stress and heart disease. Johns Hopkins cardiologists discuss this important topic.

We’ve all heard the remark: “If that person doesn’t slow down, he is going to have a heart attack.” So it’s not surprising that along with the usual advice about blood pressure, cholesterol, exercise, and diet your doctor may advise you to manage or reduce the stress in your life. Yet the presumed association between psychological or mental stress and heart disease remains just that -- a presumption.

After years of study, researchers have yet to prove that stress is a cause of heart disease or a trigger for a heart attack. But there is evidence to support a link between psychological stress and the health of your heart. For example, stress can cause you to overeat, smoke, drink too much alcohol, be physically inactive, and not take your medication -- all of which can have negative effects on your heart. It may also cause changes in your body that could make you more susceptible to heart disease and heart attacks.

Evidence: Interesting but Not Conclusive

When you are in a stressful situation, your body releases hormones to help you deal with the perceived threat. These hormones, such as epinephrine and cortisol, temporarily increase your heart rate and blood pressure. However, stress can cause other changes -- both temporary and more long lasting -- that can lead to problems for your heart.

What Should You Do? Though the evidence is not definitive, a lot of research suggests a possible link between stress and heart disease. Even if the relationship is indirect -- that is, stress causes you to engage in unhealthy behaviors or causes changes in your body that could put you at risk -- gaining control of your stress levels is important for both your physical and mental health. Here are three important steps for reining in the potential effects of stress:

1. Work with your doctor to keep track of and control any heart risk factors you may have -- from high blood pressure and high cholesterol to obesity and smoking.

2. Get regular exercise to lower your stress levels and its effects on your body. In a recent study of 134 people with coronary heart disease, those who walked or jogged for 35 minutes three times a week for four months reduced their stress levels and saw improvements in their heart rate variability and function of their blood vessels.

3. Learn some stress management techniques such as biofeedback, relaxation techniques (for example, meditation, progressive muscle relaxation, or guided imagery). These techniques can help manage your response to stress and in the process may improve some heart risk factors, too. A recent study found that meditation reduced blood pressure and blood glucose levels and improved insulin sensitivity and heart rate variability.