The Effects of Stress on Heart Health

Overall, about 5% of the U.S. adult population reports chronic stress. During the COVID-19 pandemic, there was a 25% increase in stress and anxiety worldwide, with researchers reporting the prevalence of stress, anxiety, and depression as 29.6%, 31.9%, and 33.7%, respectively.¹ 

Stress is widespread, but how it affects you is very personal. A variety of environmental, social, and emotional factors can trigger stress. The impact of stress on your health, especially your heart health, as well as its duration and severity, can vary significantly.

The Biological Impacts of Stress

When your brain perceives a stressful situation, whether or not the threat is real, it activates the sympathetic nervous system to prepare for “fight or flight” by increasing norepinephrine and epinephrine release from the adrenal medulla.

The hypothalamus, a specialized brain region, secretes hormones that stimulate the pituitary gland to release adrenocorticotropic hormone (ACTH), which prods the adrenal glands to pump cortisol into the bloodstream.

This slower stress response affects nearly every organ system in the body, particularly the heart. Stress causes an increase in heart rate, stronger heart muscle contractions, increased blood pressure, and heart dilation.²

The stress response can be lifesaving when there is a genuine threat. You can escape quickly and think more clearly. However, if stress is in response to emotional triggers or social situations over which you have no control, the stress response may not be helpful and can be detrimental to your health.³

Types of Stress

Stress can be categorized into the following types:

• Acute stress is in response to an immediate trigger. The stress response lasts minutes to days, increasing blood pressure, heart rate, and contractility. The acute stress response often fades and has no long-term health implications unless acute stress is severe or frequent.
• Chronic stress is long-term stress that causes changes in most body systems, especially if the stress occurs early in life. Chronic stress during childhood can cause permanent epigenetic, endocrine, nervous, immune, and inflammatory changes.⁴  Chronic stress is the type most likely to negatively impact heart health. Elevated stress hormones and high blood pressure can stress heart muscles and blood vessels and increase inflammation, causing damage over time.⁵
• Eustress is the stress that comes from an exciting or challenging situation. Eustress can motivate and invigorate, leading to clearer thinking and faster reactions.
• Physical stress is when the body is under undue pressure from illness, intense exercise, surgery, or injury.
• Emotional or social stress is stress in response to environmental or social demands.  

Cycle of Stress

Bodily changes in response to stress go through three stages, with the second two stages showing the effect of chronic stress.

• Alarm stage: This “fight or flight” response to acute stress increases heart rate, alertness, blood flow to muscles, and breathing rate to prepare for action.
• Resistance stage: During this phase, the acute response to stress lessons, and your body attempts to adapt to stress. However, your body remains alert, ready to respond at any time. This can lead to poor sleep, irritability, and poor concentration.
• Exhaustion stage: Prolonged stress can lead to fatigue, weakened immune function, illness, and the physical and emotional symptoms associated with chronic stress.²

Short-Term Effects of Stress on Heart Health

Short-term stress causes the heart to function more efficiently. Faster and stronger heart muscle contractions deliver oxygen and nutrients to the brain and skeletal muscle. The short-term effects of stress on the heart include:

• Increased heart rate
• Elevated blood pressure
• Reduced blood flow to heart muscle

Long-Term Effects of Stress on Heart Health

Long-term chronic stress has effects throughout the body, which can also impact the heart. The coping mechanisms many people use to manage stress, such as smoking, drinking, inactivity, and unhealthy eating habits, can also stress the heart.

Potential long-term effects of stress on the heart include:

• Obesity: Stress eating can increase the risk of being overweight and developing obesity. There is a strong correlation between obesity and heart disease, metabolic syndrome, type 2 diabetes, and abnormal blood lipids.
• Hypertension: Stress causes an increase in blood pressure. Long-term high blood pressure damages the lining of blood vessels, increasing the risk of cardiovascular disease. Hypertension is a disease without symptoms that can cause various health issues. Learn more in this complete guide to hypertension.
• Heart attacks: Prolonged stress increases many risk factors for heart attacks and heart disease, including blood pressure, inflammation, changes in cholesterol levels, and increased risk for blood clots. While there are common myths about the causes of heart disease, there is substantial research linking the effects of stress on the heart.⁶  

Other Physical Effects of Stress

Cortisol and epinephrine released during the stress response cause:

• Increased blood pressure
• Increased heart rate
• Stronger heart muscle contractions
• Increased blood flow to muscles
• Faster breathing
• Increased blood glucose levels
• Increased fat metabolism for energy
• Increased alertness
• Dilated pupils

How To Prevent Stress 

You cannot prevent your body’s stress response. However, you can mediate its impact on your health by learning how to better manage stress.

How To Reduce Stress

Lifestyle modifications and behavioral strategies shown to reduce stress include:

• Physical activity: Whether it’s movement during the day or structured exercise, aerobic exercise releases endorphins, which are natural stress and pain relievers. There are many short and long-term health effects of a sedentary lifestyle.
• Breathing exercises: Boxed breathing and other breathing exercises stimulate the vagus nerve and calm the nervous system.
• Mindfulness: Spending time in nature, mindfulness exercises, and yoga can help calm your nervous system and reduce stress.
• Nutritious Diet: Chronic stress reduces immune function and increases inflammation. A diet high in antioxidants can support immune function.
• Sleep: Restorative sleep allows the body and brain to process waste and restore essential hormones and brain chemicals.
• Goal setting: Set realistic goals within a reasonable timeframe. Avoid overcommitting and prioritize tasks to reduce psychological stress.
• Self-care: Schedule time for yourself to relax and take care of your physical and mental needs.
• Seek professional help: A mental health professional can help you learn valuable coping strategies if stress becomes overwhelming or excessive.
• Prescription medications: Talk to a healthcare provider on the TelegraMD platform. If appropriate, they may prescribe medications online to reduce acute stress symptoms.

How To Treat Heart Disease

The best way to treat heart disease is to reach out to a doctor, such as the experts on the TelegraMD platform, and receive an evaluation and online diagnosis.  

Lifestyle modifications that can improve your overall and heart health include:

• Eating a nutritious diet
• Getting 7 to 9 hours of quality sleep each night
• Starting a routine of incorporating heart-healthy exercises into your daily schedule and monitoring your progress with a wearable device
• Quit smoking, if appropriate
• Avoid excessive alcohol consumption

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider.  You should always consult a practicing professional who can diagnose your specific case.  The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. 

References

1. Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M, Rasoulpoor S, Khaledi-Paveh B. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Global Health. 2020 Jul 6;16(1):57. doi: 10.1186/s12992-020-00589-w. PMID: 32631403; PMCID: PMC7338126.

2. Chu B, Marwaha K, Sanvictores T, et al. Physiology, Stress Reaction. [Updated 2022 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541120/

3. Gunnar M, Quevedo K. The neurobiology of stress and development. Annu Rev Psychol. 2007;58:145-73. doi: 10.1146/annurev.psych.58.110405.085605. PMID: 16903808.

4. Godoy, L. D., Rossignoli, M. T., Delfino-Pereira, P., Garcia-Cairasco, N., & de Lima Umeoka, E. H. (2018). A comprehensive overview on stress neurobiology: Basic concepts and clinical implications. Frontiers in Behavioral Neuroscience, 12, 127. https://doi.org/10.3389/fnbeh.2018.00127

5. American Psychological Association. Stress effects on the body. Updated March 8, 2023. Accessed September 25, 2023. https://www.apa.org/topics/stress/body