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, eventually leading to heart attack, abnormal heart rhythms, heart failure, or stroke. Yet, 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 epinephrine (adrenaline), cortisol, and norepinephrine.

The body releases these same hormones when dealing with an episode of acute stress—for example, a situation that occurs within an instant, like when you narrowly avoid a car accident.

• 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.

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.

In play together, these hormones may trigger a higher demand for oxygen in the body, spasms in the heart’s blood vessels, and an interruption in electrical impulses, resulting in irregular heartbeats/heart palpitations, chest pain, and/or shortness of breath.

Other prolonged effects of chronic cardiovascular stress can include high blood pressure, increased heart rate, elevated blood sugar, blood vessel damage, and inflammation. And the physiological impact of stress can include damage not only to the heart, but to the overall health of the body, including weight gain, sleeplessness, irritability, headaches, or anxiety.

Broken Heart Syndrome

Broken heart syndrome—more technically known as stress-induced cardiomyopathy or Takotsubo cardiomyopathy—is an interesting medical condition. In broken heart syndrome, the heart may be physically overcome by intense emotions (grief, fear, or intense anger) or overwhelming stressful situations, causing a gush of stress hormones in the body and leading 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.

Most cases are temporary and, when treated, complete resolution of heart function is expected within a few weeks. On very rare occasions, it can be fatal. This condition brought our attention to the detrimental effects of stress on the heart and the cardiovascular system.

Inflammation and Cardiovascular Health

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

As stress hormone levels rise in the bloodstream, blood sugar levels increase, too. If 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, potentially bringing about heart attack or stroke.

Cycles of Stress

Everyone reacts differently to long-term physical or emotional tension and it 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. Lack of sleep due to worry increases cortisol and 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, intensifying 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, but 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 like high blood pressure, increased hormone production, high cholesterol, and high blood sugar often have few or no symptoms. 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.

Avoiding Stress

Patients sometimes tell me they’re experiencing heart-related symptoms like chest pain and palpitations although 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. Anxiety is a symptom that you’re under stress. Even if a person takes medication to lessen their anxiety, it doesn’t mean that the root of the problem—chronic stress—is being addressed.

Obviously, it’s not realistic to avoid stress entirely. In today’s fast-paced world, physical and emotional tensions are almost hard-wired into our lives. To reduce the effects of persistent tension on the heart, find stress-busting approaches that work for you, such as exercise, deep breathing, praying, meditation or mindfulness, yoga, or massage, to name a few.

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 and 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.

MedStar Heart & Vascular Institute Is Here for You

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

Answers to some simple questions can be really helpful in pinpointing major stress factors in their lives. It’s important to look beyond obvious medical questions and get to know someone a bit in order 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 is experiencing 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 or telehealth visit with us, even if current symptoms don’t seem urgent. We can conduct a virtual online visit with you to discuss your questions and concerns and determine if and when it is time for you to see us onsite for further attention.

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 during these tough times. We have options to help you feel safe, comfortable, and less stressed.