Psychological stress—from workplace pressure, family or relationship problems, serious financial setbacks, or general anxiety—can take a toll on your physical health. Acute, or severe, immediate stress, is known to have a direct effect on your heart. Although the mechanism isn’t fully understood, experts have some clues as to how stress affects your heart.

Here, the top four contributors to a compromised cardiovascular function:

    1. The Fight-or-Flight Response. In response to stress, your body releases hormones, such as adrenalin, as part of the “fight-or-flight” system that helps you get ready for whatever action you need to take to a avoid a threat. At the same time, this surge of hormones stimulates the heart to pump harder and faster. Blood pressure increases. If this continues, the heart becomes fatigued and weakened. In someone with atherosclerosis (plaque build-up in the arteries), this could cause a heart attack.
    2. Broken Heart Syndrome. In someone with a healthier cardiovascular system, stress hormones can still cause chest pain, shortness of breath and other symptoms of a heart attack. This condition, known as hyperadrenergic cardiomyopathy, or “broken heart syndrome,” occurs most often in women and is seen in some who suffer extreme grief and stress in response to a sudden crisis, such as the death of a child. "Broken heart syndrome is predominantly stress-related," says New Jersey-based cardiologist William A. Tansey, III, MD. "The difference between this condition and a heart attack is that there is usually no permanent damage, so broken heart syndrome is almost always reversible."
    3. Post-Traumatic Stress Disorder. Researchers at the University of California, San Diego, noted an increasing body of evidence pointing to a potential link between post-traumatic stress disorder (PTSD), a condition that develops after exposure to highly stressful situations such as acts of war or terrorism, and the development of cardiovascular disease. Although the underlying mechanism is unknown, the researchers found that physical changes occurring in the bodies of those with PTSD, including altered brain chemistry, inflammation, and hormonal dysfunction, all potentially damage the heart. Studies of adults who suffered ongoing anxiety and high stress in response to the terror attacks of 9/11 also showed a strong link between stress and heart disease.
    4. Unhealthy Behaviors. Some experts say that the lifestyle choices people often make while under stress, such as eating more junk food, smoking, drinking alcohol, taking drugs, and not making time for exercise, are also responsible for the link to coronary disease. These behaviors are known to contribute to the formation and build-up of plaque in the arteries that can lead to heart attack and stroke.

What can you do? The short answer is: whatever it takes to alleviate stress in your life. A great place to start, according to Tansey, is with physical exercise, which uses up adrenalin. Other relaxing activities, such as meditation, deep breathing, listening to music, watching a comedy show, spending time with friends or relatives, or playing with your dog can all help alleviate stress.

William A. Tansey, III, MD, FACC, reviewed this article.


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Parswani MJ, Sharma MP and Iyengar SS. “Mindfulness-Based Stress Reduction Program in Coronary Heart Disease: A Randomized Control Trial.” Int J Yoga 2013 Jul-Dec;6(2):111-117. Steptoe A and Kivimaki M. “Stress and Cardiovascular Disease.” Nat Rev Cardiol. 2012 Apr 3;9(6):360-70. 

Wentworth BA, Stein MB, Redwine LS, et al. “Post-Traumatic Stress Disorder: A Fast Track to Premature Cardiovascular Disease?Cardiol Rev. 2013 Jan-Feb;21(1):16-22.