“I was so stressed out, I thought I’d have a heart attack!” Ever heard yourself say something like that? Obviously, we generally don’t mean such statements literally, but they reflect the level of agitation we experience, both emotionally and physically, when we are dealing with extreme stress in our lives.

But does stress really play a role in our heart health? Research indicates that it does, though there is still a lot that we don’t fully understand about the details of that role.

We all know by now that there are certain risk factors for heart disease. Some are things that we can’t do anything about, like age, gender and family history of cardiac disease. Others are factors over which we do have some control – like whether or not we smoke, our diet and exercise habits, and how we cope with stress. These are called modifiable risk factors, so our energy is well spent reducing their potential to negatively impact heart health.

A study was published last fall in the American Journal of Cardiology that looked at the relationship between how stressed people perceived themselves to be and their risk of heart attacks and death from coronary heart disease (CHD). On average, the 120,000 patients involved in six different studies were followed over a period of 14 years, and the results indicated that a high level of perceived stress was associated with a 27 percent increase in risk for a new CHD diagnosis or hospitalization, or CHD death. Since CHD is the leading cause of death in the United States for both men and women, this seems like information that we should pay attention to.

How does stress affect your heart?

When we are stressed, the body’s “fight-or-flight” response kicks in. The rush of stress hormones, like adrenaline and cortisol, increases heart rate and blood pressure, releases fats into the bloodstream, tenses muscles, and increases the blood’s clotting ability. This primitive, built-in response is meant to protect us from danger, but it does have a down side too.

Acute versus chronic stress

If your stress level is fairly manageable and every once in a while the fight-or-flight response kicks in, it’s really no big deal. The spike of stress hormones will recede fairly quickly, and the physiological response with heart rate, blood pressure, etc., will go back to normal. But what about those of us who have frequent stressors day in and day out? When the stress response is triggered repeatedly over time, that chronic physiological reaction may begin to take a toll on the cardiovascular system. Elevated blood pressure increases risk of heart disease and stroke. Increased levels of cholesterol and triglycerides in your bloodstream increases risk of plaque build-up in the arteries. An increased heart rate triggered by stress could lead to abnormal heart rhythm or problems with the heart muscle itself.

Stress and health behaviors

Another way that stress can affect our hearts is by its impact on how we take care of ourselves. Many people tend to turn to junk food or overeating when stressed. Some former smokers may pick up the cigarettes again when stress levels increase. When we are coping with the time crunch of dealing with urgent life events, it’s easy to let exercise go by the wayside because we are just too busy. Some might even cope by drinking more alcohol or using other drugs to “unwind.” Our health behaviors may take a turn for the worse at the exact time that we need to maintain them in order to counteract the negative effects of stress.

So what can I do?

Stress is part of life, so we can never eliminate it completely. But it’s smart to look at the stressors in your life and think about what could be done to reduce some of them and to cope with the stress that will remain. Here are some strategies that you might try to bring your stress level down a notch or two:

  • Notice the things that tend to cause you stress and accept that there will be certain things you cannot change (like that traffic jam you’re stuck in).
  • Take care of your body with a healthy diet, regular physical activity, getting enough sleep and staying away from tobacco. Don’t let stress lead you to increase your risk by letting health habits take a turn for the worse.
  • Practice the “relaxation response.” You can learn to slow yourself down physically and mentally in a way that can lower heart rate, blood pressure and breathing, serving to counterbalance the increased reactivity that comes with the flight-or-flight response. This can be done with a variety of approaches, including relaxation training, meditation, or guided imagery. Experiment to find one that you like and that seems to work for you.
  • Change your “self-talk.” Are you constantly seeing problems as catastrophes and having difficulty keeping concerns in perspective? The advice to not “sweat the small stuff” is good, but not always easy to do. Pay attention to your own thoughts when you are stressed and learn to talk back to yourself as you would when you are reassuring a good friend who is upset. We’re usually kinder and more rational in assessing other people’s problems, so try turning that same attitude on yourself.
  • Seek help when you need it. If you are having a hard time coping with the stress in your life, you might benefit from working with a counselor or taking a stress management class. There are also many good self-help books and CDs on the market that can give you ideas for mastering new coping skills.

As research continues, I’m sure that we will be learning more about how stress affects our heart function. Hopefully, that will guide us in generating approaches to most effectively reduce the impact of stress on our health. In the meantime, let’s use what we already know about the mind-body connection to lower our cardiac risk as much as we can.