August 27, 2024
Everyone feels pressure and stress. It could be a looming work deadline, caring for an ill or injured loved one, or crushing financial strain. But the amount of stress you experience and how you handle it can impact your heart health.
“Everybody knows that smoking is unhealthy and a big risk factor for heart disease,” says MU Health Care cardiologist Dr. Marc Shelton. “People need to realize that stress is also a major risk factor — and often, we can’t stop stress from happening.”
Even if you can’t hide from stress, you can acknowledge the power of stress and work to reduce its effects. Dr. Shelton shares what you need to know about stress and your heart:
How Does Stress Affect Your Cardiovascular System
There are two different kinds of stress, and they can both impact your heart:
Acute Stress
Acute stress, which can last from a few seconds up to a few weeks, occurs when you’re thrown into a stressful situation, such as a near-miss car accident or a big project with a tight deadline. It tends to come on quickly and go away quickly, and so do most of its effects on your body.
Your “fight or flight” reaction to acute stress increases your:
- Blood pressure: The force your blood puts on arteries as it travels through the body
- Heart rate: Heartbeats per minute
“These reactions to stress, though temporary, increase your short-term risk of a heart-related event, especially if you have existing heart disease,” Dr. Shelton says. “Occasionally, acute stress can bring on sudden events such as stroke, heart attack or ruptured plaque.”
Plaque (coronary artery disease) is a build-up of fats and cholesterol that narrows your arteries and blocks blood flow. When it ruptures, a blood clot can form, narrowing the artery even more. If you already have heart disease, research shows that acute stress can reduce blood flow through your heart (ischemia), more than doubling your risk of heart attack.
Chronic Stress
Chronic stress, which lasts months to years, puts the body in a constant state of tension or anxiety — think unemployment, a disease diagnosis or being a single parent.
“Both types of stress impact your heart,” Dr. Shelton says. “But chronic, ongoing stress is the type of stress we worry about most with cardiovascular health.” Over time, chronic stress can cause heart issues. It can also make existing heart problems worse.
Chronic stress may impact heart health in many ways:
1. Causes Inflammation
Your immune system responds to stress by releasing the hormones adrenaline and cortisol. These stress hormones give you the energy you need to escape a dangerous situation. But when you’re chronically stressed, your overactivated immune system and elevated levels of stress hormones can lead to inflammation.
Inflammation is linked to high blood pressure and lower HDL (“good”) cholesterol. It can also encourage plaque build-up in the arteries and may cause existing plaque collection to rupture.
“We believe plaque builds more quickly when inflammation is present,” Dr. Shelton says. “It’s one reason some people think GLP-1 drugs may reduce cardiac events — they treat diabetes and weight loss, but we know they reduce inflammation.”
2. Increases Blood Pressure
Stress hormones cause your blood vessels to constrict, which increases your blood pressure. When stress is chronic, ongoing elevated blood pressure can damage and tear blood vessel walls. When your body repairs those tears, it can lead to plaque formation.
“Plaque doesn’t form daily,” Dr. Shelton says. “You won’t have symptoms when the build-up is early. Once it becomes significant, it can cause heart-related symptoms. But it can all start with high blood pressure.”
3. Impacts Heart Rate
A normal heart rate is 60 to 100 beats per minute (BPM). During acute stress, your heart rate can reach over 100 BPM. While your heart rate may not always be that high with chronic stress, it tends to be elevated for long periods, forcing your heart to work harder more often.
“A consistently high heart rate — even if it’s still in the normal range — can take a toll on your heart,” Dr. Shelton says. “When you combine that wear and tear with the elevated blood pressure and inflammation associated with stress, it greatly increases your risk of a cardiac event.”
4. Affects Other Cardiovascular Risk Factors
When you feel stressed, it’s easy to loosen the reigns around healthy habits. You may find yourself:
- Eating out more often or choosing unhealthy food
- Forgetting to take prescription medication
- Skimping on sleep, staying up too late to finish the project or get housework done
- Skipping your daily exercise
- Taking the edge off with cigarettes or alcohol
“One of the most critical impacts of chronic stress is that it often leads to or worsens unhealthy tendencies,” Dr. Shelton says. “Diabetes and obesity are risk factors for heart disease. When chronic stress leads you to make unhealthy choices, you’re at higher risk for several chronic diseases.”
Tips for Reducing Stress to Protect Your Heart Health
Dr. Shelton recommends doing whatever you can to reduce your stress and understand your heart health, including:
Get a Baseline Screening for Heart Health
The best way to protect your heart is to spot and address issues early. MU Health Care’s Love Your Heart Cardiac Screening offers an easy way to assess your heart health now and in the future. A quick scan of your heart can show if there is any evidence of early plaque build-up.
“Mild plaque build-up contains calcium,” Dr. Shelton says. “A CT scan of your heart can pinpoint calcium to identify plaque build-up, even if it’s too small to be felt or cause problems.”
If you have some early plaque, you may need to work harder to modify your lifestyle to decrease risk. Dr. Shelton adds that it’s best to get a baseline test done so you have something to compare with future tests.
Identify Your Stress Level
You may not have symptoms of heart disease, but there are usually telltale signs that you are stressed. Stress can show up as:
- Body pains
- Headache
- Mood swings
- Rash
- Stomachache
- Trouble sleeping
“Everyone has stress in their lives,” Dr. Shelton says. “Ask yourself, ‘Are you feeling more stressed now than you were five years ago? Why? How is it affecting your daily life?’ Those questions can help you evaluate your level of stress.”
Reduce Your Stress
You can’t always remove the stressors in your life, but you can find ways to relieve the effects of stress. Dr. Shelton recommends adjusting your:
- Diet: Eating more vegetables and less meat will help reduce inflammation.
- Exercise: Light exercise, such as walking or biking for 20 minutes, will reduce your heart rate and blood pressure.
- Mental health: Find ways to shift stressful thoughts. Consider listening to music, practicing gratitude, meditating or throwing yourself into a hobby.
Be Mindful of Risk Factors You Cannot Change
Stress has a more significant impact on your heart if you’re at high risk or already have heart disease. Being aware of uncontrollable risk factors, such as age and family history, can serve as added motivation to reduce your stress.
“As we age, blood pressure tends to go up — in men more than women. Family history also plays a critical role,” Dr. Shelton says. “If you and your doctor determine you are high risk, you
may need to take additional steps to manage that risk. But reducing stress is always a step in the right direction for heart health.”
Next Steps and Useful Resources
- Ready to get your baseline heart health screening? Schedule a Love Your Heart cardiac screening.
- Want to discuss more with a doctor? Find one today.
