Stress and your heart: MedlinePlus Medical Encyclopedia

P Stress is the way your mind and body react to a threat or a challenge. Simple things, like a crying child, can cause stress. You also feel stress when you're in danger, like during a robbery or car crash. Even positive things, like getting married, can be stressful.
P Stress is a fact of life. But when it adds up, it can affect your mental and physical health. Too much stress can also be bad for your heart.

T Your Body and Stress
P Your body responds to stress on many levels. First, it releases stress hormones that make you breathe faster. Your blood pressure goes up. Your muscles tense up and your mind races. All of this puts you in gear to deal with an immediate threat.
P The problem is that your body reacts the same way to all types of stress, even when you're not in danger. Over time, these stress-related reactions can cause health problems.
P Common symptoms of stress include:
- Upset stomach
- Inability to focus
- Trouble sleeping
- Headaches
- Anxiety
- Mood swings

T Stress and Heart Disease
P When you are stressed, you are also more likely to do things that are bad for your heart, such as smoke, drink heavily, or eat foods high in salt, sugar, and fat.
P Even on its own, constant stress can strain your heart in several ways.
- Stress raises blood pressure.
- Stress increases inflammation in your body.
- Stress can increase cholesterol and triglycerides in your blood.
- Extreme stress can make your heart beat out of rhythm.

T Harmful Kinds of Stress for Your Heart
P Some sources of stress come at you fast. Others are with you every day. You can protect yourself from some stress. But other stressors are beyond your control. All of these factors have an impact on how stressed you feel and for how long.
P The following types of stress are the worst for your heart.
- Chronic stress. The daily stress of a bad boss or relationship woes can put constant pressure on your heart.
- Helplessness. Chronic stress is even more harmful when you feel unable to do anything about it.
- Loneliness. Stress can be more harmful if you do not have a support system to help you cope.
- Anger. People who blow up in anger have a higher risk of heart attack and stroke.
- Acute stress. In rare cases, extremely bad news can bring on heart attack symptoms. This is called broken heart syndrome. This is not the same thing as a heart attack, and most people recover fully.

T When you Have Heart Disease
P Heart disease itself can be stressful. Many people feel anxious and depressed after a heart attack or surgery. This is natural, but it can also get in the way of recovery.
P Stress may be more damaging if you have heart disease. You might feel more pain, have more trouble sleeping, and have less energy for rehab. Depression can also increase your risk for another heart attack. And it can make it harder for you to believe you will be healthy again.

T What you can do
P It is important to learn how to manage stress. Finding healthy ways to deal with stress can improve your mood and help you avoid unhealthy behaviors, like overeating or smoking. Try different ways to relax, and see what works best for you, such as:
- Practicing yoga or meditation
- Spending time outdoors in nature
- Getting regular exercise
- Sitting quietly and focusing on your breathing for 10 minutes each day
- Spending time with friends
- Escaping with a movie or a good book
- Making time every day for the things that reduce stress
P If you are having trouble managing stress on your own, consider a stress management class. You can find classes at local hospitals, community centers, or adult education programs.

T When to Call the Doctor
P Call your health care provider if stress or depression makes it hard to do daily activities. Your provider may recommend therapy to help you get stressful events or feelings under control.

T Alternative Names
P Coronary heart disease - stress; Coronary artery disease - stress

T References
P Cohen BE, Edmondson D, Kronish IM. State of the art review: Depression, stress, anxiety, and cardiovascular disease. Am J Hypertens. 2015;28(11):1295-302. PMID: 25911639 www.ncbi.nlm.nih.gov/pubmed/25911639.
P Crum-Cianflone NF, Bagnell ME, Schaller E, et al. Impact of Combat Deployment and Posttraumatic Stress Disorder on Newly Reported Coronary Heart Disease Among US Active Duty and Reserve Forces. Circulation. 2014;129(18):1813-1820. PMID: 24619462 www.ncbi.nlm.nih.gov/pubmed/24619462.
P Jiang W, Samad Z, Boyle S, et al. Prevalence and clinical characteristics of mental stress-induced myocardial ischemia in patients with coronary heart diseas. J Am Coll Cardiol. 2013;61(7):714-22. PMID: 23410543 www.ncbi.nlm.nih.gov/pubmed/23410543.
P Vaccarino V, Bremmer JD. Psychiatric and behavioral aspects of cardiovascular disease.  In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 86.
P Wei J, Rooks C, Ramadan R, et al. Meta-analysis of mental stress-induced myocardial ischemia and subsequent cardiac events in patients with coronary artery disease. Am J Cardiol. 2014;114(2):187-92. PMID: 24856319 www.ncbi.nlm.nih.gov/pubmed/24856319.
P Williams RB. Anger and mental stress-induced myocardial ischemia: Mechanisms and clinical implications. Am Heart J. 2015;169(1):4-5. PMID: 25497241 www.ncbi.nlm.nih.gov/pubmed/25497241.

T Review Date 2/24/2016
P Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

T Related MedlinePlus Health Topics
- How to Prevent Heart Disease
- How to Prevent High Blood Pressure
- Stress

