Manage Stress to Maintain Heart Health

By Dr. Carolyn Davidson, Elliot Cardiovascular Consultants 

We all experience stress; however, chronic, long-term stress can have a profound impact on heart health. In a large study, stress was one of the three most powerful predictors of heart attacks, along with smoking and cholesterol. In a fast-paced and demanding world, stress has become a common companion for many, and understanding how it affects your heart may save your life. 

The impact of stress on the heart

Stress triggers the body's "fight or flight" response, releasing hormones including adrenaline and cortisol. While this response is essential for survival in threatening situations, chronic stress can lead to prolonged elevation of these hormones, adversely affecting the heart in three key ways. 

• Increased blood pressure and heart rate (and risk for arrhythmias): The surge of hormones such as adrenaline during stressful situations causes the heart to beat faster and blood vessels to constrict, leading to elevated blood pressure. Over time, persistent high blood pressure can strain the heart and arteries. Arrhythmias, or abnormal rhythms, can lead to weakening of the heart or can lead to sudden cardiac death. 
• Inflammation: Chronic stress contributes to inflammation in the body. Inflammation is a key factor in cardiovascular diseases, as it can damage blood vessels, promote the formation of plaques, and has been shown to increase the risk of a heart attack. 
• Blood clotting: Stress can make blood more prone to clotting. Clots can obstruct blood flow, leading to heart attacks, strokes, or reduced blood flow to other organs or limbs. 

The impact of stress on heart disease

In addition, stress may create or have serious effects on existing heart diseases.  

• Coronary artery disease (CAD): Chronic stress is associated with an increased risk of developing CAD. The combination of elevated blood pressure, inflammation, and altered blood clotting can contribute to the narrowing of coronary arteries. 
• Hypertension: Stress-induced high blood pressure is a significant risk factor for hypertension, a condition that can strain the heart and increase the likelihood of heart attacks, strokes, and other cardiovascular events. 
• Arrhythmias: Stress may contribute to irregular heartbeats or arrhythmias. These disruptions in the heart's rhythm can be dangerous or even fatal, especially in individuals with pre-existing heart conditions. 
• Metabolic syndrome: Stress can contribute to obesity, type 2 diabetes, and abnormal lipids, all of which can contribute to vascular disease. 

Steps for managing stress

Fortunately, there are steps you can take to reduce your stress and the likelihood of stress-related heart disease. 

• Mind-body techniques: Practices like meditation, deep breathing exercises, and mindfulness can help manage stress levels. These techniques promote relaxation and have been shown to positively impact heart health. There are countless apps that can guide you or you can join a local or online class. 
• Regular exercise: Physical activity is a natural stress reliever and has numerous benefits for heart health. It helps lower blood pressure, improves circulation, and reduces inflammation. Aim for 20-30 minutes of movement each day. Take a walk when you are feeling particularly stressed.  
• Healthy lifestyle choices: Quit smoking. This is one of the most important things you can do to protect your heart. Limiting alcohol and caffeine intake is also helpful for maintaining overall health and reducing the impact of stress on the heart. 
• Follow a healthy diet: Every person should aim for five servings of fruits and vegetables every day, as it decreases your chance of heart attack or stroke. Cut out sodium and processed foods, particularly meats and cheeses (such as lunch meat, hot dogs, sausage, bacon, and American cheese). The Mediterranean Diet is the most recommended diet (also encouraged by AHA/ACC). The DASH diet is also good, as it is high in fruits and vegetables and focuses on cutting out sodium. 
• Get adequate sleep: Adults should sleep about seven to nine hours a night for optimal health. If you have trouble sleeping, your primary care provider may suggest techniques or medications to help. 
• Social connections: Strong social support networks can act as buffers against stress. Engaging in meaningful relationships and fostering a sense of community can have positive effects on mental and cardiovascular health.

The relationship between stress and heart health is complex. If you are concerned about stress and your heart health, talk to your primary care provider. They will have suggestions that may help, and they may refer you to a cardiologist for specialized care.