The Effects of Stress on the Heart.

When it comes to activities that affect the heart, there’s the good (a healthy lifestyle), the bad (unhealthy risk factors), and the ugly (hidden influences).

Excessive stress is often found among the “ugly.” Behind the scenes, stress can work persistently to damage the heart. It can lead to heart attack, abnormal heart rhythms, heart failure, or stroke. Even then, an affected person may be completely unaware that stress is an underlying cause of his or her heart issues.

Powerful hormones at work.

Research shows a relationship between chronic stress and abnormal production of the stress hormones. These hormones are :

• Adrenaline: Increases the heart rate, raises blood pressure, and increases energy supplies.
• Cortisol: Floods the bloodstream with glucose and narrows the arteries.
• Norepinephrine: Raises the heart rate, releases glucose into the bloodstream, and increases blood flow to the muscles.

The body releases these same hormones when dealing with an episode of acute stress. This can be any situation that occurs within an instant, such as narrowly avoiding a car accident. But when the body experiences chronic stress—day after day, for an extended period of time—these hormones can start to have a detrimental effect on heart health.

Together, these hormones can trigger a higher demand for oxygen in the body, blood vessel spasms, and interruption of electrical impulses. This can result in heart palpitations, chest pain, and shortness of breath.

Other effects of chronic cardiovascular stress can include high blood pressure, increased heart rate, elevated blood sugar, blood vessel damage, and inflammation. Effects on overall health can include weight gain, sleeplessness, irritability, headaches, or anxiety.

Broken heart syndrome.

Broken heart syndromeis an interesting medical condition. Doctors more often call it stress-induced cardiomyopathy or Takotsubo cardiomyopathy. In broken heart syndrome, the heart may be physically overcome by intense emotions (grief, fear, or intense anger) or overwhelming stressful situations. This causes a gush of stress hormones in the body and leads to symptoms and signs that mimic a heart attack and/or heart failure.

Stress cardiomyopathy symptoms include sudden chest pain, shortness of breath, sweating, fast heart beats, and dizziness. Up to 30% of people who experience this condition are unaware of what triggered their symptoms.

Thankfully, most cases are temporary. When treated, complete resolution of heart function is expected within a few weeks. On very rare occasions, it can be fatal.  This condition highlights how stress affects the heart and cardiovascular system.

Inflammation and cardiovascular health.

High stress can also affect the heart and cardiovascular system by spurring inflammation in the arteries. This is a risk factor for atherosclerosis/hardening of the arteries.

As stress hormone levels rise in the bloodstream, blood sugar levels increase, too. Sometimes, those sugar levels exceed the body’s needs. They can trigger an inflammatory response within the walls of the blood vessels. When this inflammation occurs, cholesterol-rich plaque can build in the arteries. This can bring about heart attack or stroke.

Cycles of stress.

Everyone reacts differently to long-term physical or emotional tension. Tension can be more damaging to some than to others. For instance, someone experiencing chronic aggravation or worry may eat more, leading to weight gain. 

Increased weight may raise blood pressure and trigger the risks inherent in diabetes. Similarly, lack of sleep due to worry increases cortisol. Excess cortisol has been tied to high blood sugar and increased body weight.

All these factors are detrimental to the condition of the heart. And stress may cause some people to compromise their hearts even further through unhealthy lifestyle choices such as smoking or alcohol abuse. These can intensify stress on the cardiovascular system.

A particularly ugly aspect of chronic tension is that we frequently don’t recognize its effect on us. We’ve all heard that smoking is bad for your health and bad for your heart. However, it may never occur to us that chronic stress is harmful to our hearts as well. It’s time to recognize the negative role that it can play.

Remember, the effects of stress and anxiety on the heart may not be readily apparent. Serious conditions  often have few or no symptoms. These include high blood pressure, increased hormone production, high cholesterol, and high blood sugar. Yet their long-term impact can be profound. The crucial role of screening for these conditions and being proactive about our health can’t be overemphasized.

Related Reading: Stress First Aid: A Practical Approach to Caring For Your Mental Health.
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Avoiding stress.

Patients sometimes tell me they have heart-related symptoms such as chest pain and palpitations. Often, follow-up testing shows no clear medical reason for their symptoms. Later, they realize that their symptoms, which were temporary, had aligned with a particularly stressful period in their lives. Their hearts were reacting to stress.

Stress is a mechanism that affects your body and can cause anxiety. Even if a person takes medication for anxiety, it doesn’t mean that the root of the problem—chronic stress—is being addressed.

In today’s fast-paced world, physical and emotional stress is almost hard-wired into our lives. To reduce the effects of persistent tension on the heart, find stress-busting approaches that work for you. Exercise, deep breathing, praying, meditation or mindfulness, yoga, or massage, can all be helpful.

For anyone living with heart disease or risk factors for heart disease (e.g. hypertension, high heart rate, diabetes), it’s important to actively reduce stress factors. There are steps you can take to follow a heart-healthy lifestyle:

• Quit smoking. It’s one of the best things you can do for your heart and overall health.
• Manage diabetes. It’s a serious risk factor for heart disease.
• Eat healthy. Explore approaches to healthy eating, such as the heart-friendly Mediterranean diet.
• Consider intermittent fasting or other eating patterns that can encourage weight loss. Consult your doctor to be sure the approach you take is safe for you.
• Stay active. Break out of a sedentary lifestyle. You don’t need to run marathons. Walking is excellent for your cardiovascular system.
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MedStar Heart & Vascular Institute is here for you.

When I meet a new patient, I ask about their lifestyle—work, family, habits, exercise, diet, and stressors large and small. 

Asking simple questions can help to pinpoint major stress factors. It’s important to look beyond obvious medical questions and get to know someone to help resolve their heart health issues. Patients may not even realize that their work, commute, or family situation is directly connected to heart symptoms. 

My message to anyone who has heart symptoms, stress-related or not: don’t delay care. If you are concerned about the effects of chronic stress on your heart, schedule a cardiology appointment, even if current symptoms don’t seem urgent. We can conduct a virtual online visit to discuss your questions and concerns. We’ll determine if and when it is time for you to see us on site for further care. 

We have state-of-the-art diagnostic equipment and a variety of other resources to help deliver the safest and best care to our patients. We have options to help you feel safe, comfortable, and less stressed.