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How can Stress Increase the Risk for Cardiovascular Disease?

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how can stress increase the risk for cardiovascular disease

Stress typically has a negative connotation, but there can be a positive side to it. As it happens, the body’s response to anxiety is a means of protection. For instance, in case of danger, such as being in a burning building, a person’s stress response can help them avoid getting hurt. 

However, constant pressure can significantly impact physical and mental well-being 

In fact, according to a report by the American Psychological Association (APA), 2022 Stress in America, 76% of adults experience a physical and emotional toll because of stress. 

Consequently, long-term tension can contribute to the development of many medical issues, including heart conditions. Many studies, such as Dimsdale’s Psychological Stress and Cardiovascular Disease, have found that stress can increase the risk for cardiovascular disease (CVD). 

This article will explore the connection between stress and heart disease, the most common heart problems, and their risk factors and symptoms. In addition, it will dive into the role of stress management and cardiovascular health programs in preventing coronary conditions. 

The Effects of Acute and Chronic Stress on the Heart

Is stress a significant factor contributing to the risk of heart disease? How exactly does stress affect the cardiovascular system? These questions have gained increasing attention as researchers delve into the intricate relationship between stress and heart problems. 

Stress is an inevitable part of our lives, stemming from various sources, both physical and emotional. Sleep deprivation, illness, financial concerns, the loss of a loved one, and the pressures of daily responsibilities are among the myriad triggers that can induce stress. Stress can be either acute (short-term) or chronic (long-term). 

Despite its normalcy, stress can become problematic when it persists over extended periods. 

Common responses to stress are manifold and can include physical discomfort, diminished energy levels, disturbed sleep patterns, as well as feelings of anxiety, anger, and depression. Impatience and forgetfulness can also manifest as stress-related symptoms. 

But is stress a factor that contributes to heart disease risk?  

The Link Between Stress and Cardiovascular Disease

In its scientific statement Psychological Health, Well-Being, and the Mind-Heart-Body Connection, the American Heart Association (AHA) claims that “there is good data showing clear associations between psychological health and cardiovascular disease and risk.” 

So, what is the relationship between stress and heart disease? Is stress bad for your heart?   

According to the findings, various distress sources impact the heart’s health, and work-related strain increases the risk of CVD by 40%. Additionally, there is a 50% increase because of social isolation and solitude as stressors. Posttraumatic stress disorder (PTSD) also increases the risk of cardiac events by 61%.

how can stress increase the risk for cardiovascular disease

But how does chronic stress affect the heart 

A study published in The Lancet titled “Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort studyclaims to show how tension is linked to coronary issues.  

The researchers found that when people are stressed, their amygdala (a brain area dealing with anxiety) signals to the bone marrow to produce more white blood cells. Excess white cells can cause the arteries to become inflamed, and inflammation is a risk factor leading to heart attacks and strokes. 

Another study, “Urinary Stress Hormones, Hypertension, and Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis,” determined that spikes in stress hormones, such as cortisol, increase the risk of heart issues.  

Namely, people without other risk factors who have increased levels of hormones are more likely to develop hypertension. The greater the hormone levels, the higher the risk of high blood pressure. Over time, the cardiovascular risk rises by 90% with each doubling of the hormone levels. 

So, how does stress increase the risk of cardiovascular disease? Stress can increase the risk of cardiovascular disease by: 

  • Increasing the levels of stress hormones, such as cortisol. 
  • Damaging the arteries. 
  • Increasing the risk of heart arrhythmias. 
  • Weakening the heart muscle. 
  • Promoting unhealthy behaviors, such as smoking, overeating, and lack of physical activity. 

General Adaptation System: The Body’s Response to Stress

General adaptation syndrome (GAS) is the process that describes how the body responds to stress. Hans Selye was the first doctor who identified this theory in 1946.As per his report, there are three stages of the syndrome. During each one, the body goes through various psychological changes. 

1. Alarm reaction stage  

This is the first phase, during which the body experiences the initial symptoms of distress. The brain releases glucocorticoids and adrenaline hormones, setting up the “flight-or-fight” response. 

The body’s signals during this stage include elevated blood pressure, increased heart rate, dilated pupils, heightened senses, and flushed skin. 

2. Resistance stage  

In this stage, the body deals with the changes that occur in the reaction stage and tries to repair itself. Although it is recovering, it remains on high alert. If the person overcomes the stressful event, the body will continue rebuilding and eventually return to a pre-stressed state.  

However, the reaction stage can become permanent if a person remains tense. The body will learn to live on high alert, constantly producing stress hormones and increasing blood pressure. This triggers the exhaustion stage. 

The most common signs of the resistance stage are irritability, frustration, and poor concentration. 

3. Exhaustion stage 

If the pressure becomes long-term, it can send the body into exhaustion.  

Chronic stress drains the physical, emotional, and mental capacity to a point where the body no longer has the strength to fight it. The physical toll of this phase weakens the immune system, increasing the risk of stress-induced conditions. 

Signs of the exhaustion stage include anxiety, depression, fatigue, burnout, and lower pressure tolerance. 

While GAS is not a condition that needs to be treated, people must learn how to recognize it. Chronic stress can increase the risk for cardiovascular diseases and other medical conditions. 

Heart Disease Risk Factors

Health conditions, lifestyle, age, and family history increase the risk of developing heart issues, which are all considered risk factors. According to an NCHS Data Brief, about half of Americans have at least one to three major heart disease risk factors. 

They are separated into two categories: major and contributing.  

The leading major risk factors for cardiovascular disease include:  

  1. High blood pressure (hypertension)  
  2. High blood cholesterol 
  3. Diabetes 
  4. Obesity and overweight 
  5. Smoking and vaping 
  6. Physical inactivity 
  7. Gender 
  8. Age 
  9. Heredity 

The most common contributing risk factors for cardiovascular disease are:  

  1. Stress 
  2. Sleep hygiene 
  3. Alcohol 
  4. Diet and nutrition 

Risk factors such as gender, age, and heredity cannot be changed or treated. However, the majority can be controlled with lifestyle changes and medications. 

how can stress increase the risk for cardiovascular disease

Cardiovascular Disease Symptoms

Cardiovascular diseases include a range of conditions that affect the heart.  

Each illness presents different symptoms. Below is a table of the most common heart issues and their symptoms.



Coronary Artery Diseases 

  • Chest pain, tightness, pressure, or discomfort  

  • Shortness of breath  

  • Pain in the neck, throat, or jaw  

  • Pain, numbness, or weakness in the extremities 

Heart Arrhythmias 

  • Chest pain or discomfort 

  • Shortness of breath  

  • Lightheadedness  

  • Dizziness  

  • Fainting  

  • Tachycardia, or bradycardia. 

Congenital Heart Defect 

  • Swelling in legs, belly area, or eyes  

  • Pale gray or blue skin or lips  

  • Shortness of breath during feeding (in infants) or during exercise (in adults)  

  • Swelling of hands, feet, or ankles. 


  • Fatigue  

  • Shortness of breath during or after an activity, at night, or when waking up  

  • Irregular heartbeats  

  • Dizziness  

  • Lightheadedness 

  • Fainting  

  • Swelling of legs, feet, or ankles. 

Valvular Heart Disease 

  • Chest pain  

  • Fatigue  

  • Fainting  

  • Shortness of breath  

  • Irregular heartbeat  

  • Swelling of feet or ankles. 


  • Dry cough  

  • Fever  

  • Changes in heartbeat  

  • Shortness of breath  

  • Fatigue  

  • Skin rashes  

  • Swollen legs 

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The Difference Between Panic & Heart Attacks

Although panic and heart attacks share similarities, they result from different processes. Panic attacks happen when stress triggers the body’s flight-or-fight hormones, elevating the heart rate. A heart attack occurs when the heart doesn’t get enough blood. 

AHA’s statistics show that someone has a heart attack every 40 seconds in the US. When it comes to panic attacks, the Anxiety and Depression Association of America (ADAA) reported that 2-3% of Americans have panic attacks within a year. 

Both conditions’ symptoms are similar, including chest pain, shortness of breath, dizziness or lightheadedness, cold sweat, and a racing heartbeat. 

However, specific differences can help differentiate between the two.  

Panic attacks most often happen due to mental or emotional stress. Heart attacks occur after physical strain or exertion. However, it must be noted that there is a close relationship between constant emotional stress and heart attacks. 

In the case of a panic attack, the pain typically stays in the chest. During a heart attack, the pain may also radiate to the arms, neck, or jaw.  

During a panic attack, the pain feels sharp and stabbing, accompanied by a racing heart and chest discomfort. The heart attack pain feels like chest pressure and is accompanied by an achy or burning sensation, like heartburn. 

Pain attack symptoms typically last from a few minutes to an hour. Heart attack symptoms don’t go away. They might ebb and flow in waves and keep getting better or worse over time. 

Stress-Induced Heart Problems

Can stress and anxiety cause coronary heart disease? 
stress can increase the risk of cardiovascular diseases, it can also lead to heart muscle weakness. This stress-induced heart problem is called broken heart syndrome, also known as Takotsubo cardiomyopathy. 

According to a report by the AHA, broken heart syndrome occurs in less than 5% of the population. Most cases prevail among women (88.3%). 

This coronary stress disease can result from both physical and emotional anxiety. Examples of emotional stressors include grief, intense fear, surprise, or extreme anger. The most common physical stressors are severe pain, health issues, and exhaustion. 

So how does distress lead to broken heart syndrome?  

When a person experiences stress, the body produces adrenaline to cope with the pressure. A massive amount of adrenaline produced in such situations can overwhelm the heart.  

The exact cause of broken heart syndrome is not fully understood, but it is thought to be due to a combination of factors, including stress hormones, inflammation, and changes in the electrical activity of the heart. 

The symptoms of a broken heart syndrome mimic those of a heart attack. The three main ones are sudden, severe chest pain, shortness of breath, and weakening of the heart’s left ventricle. Other symptoms include arrhythmia, hypertension, sweating, or dizziness.  

They can occur minutes or hours after a stressful event. 

The Role of Stress Management in Cardiovascular Disease Prevention

Psychological stress and cardiovascular diseases are strongly associated. Hence, taking control of and learning to manage the constant anxiety can help reduce that risk. 

The first step towards stress management is identifying the stressors. Pinpointing significant ones, such as going through a divorce or moving, is more manageable. But sometimes, thoughts, feelings, and behaviors could also be sources of tension.  

Once the stressors are determined, the next move is to find ways to reduce stress levels. There are a few strategies that can help a person feel less tense: 

  • Trying breathing exercises 
  • Practicing relaxation techniques 
  • Utilizing mindfulness and meditation 
  • Getting physical exercise and good nutrition 
  • Building a sound support system 
how can stress increase the risk for cardiovascular disease

Heart Disease & Mental Health

 It is a common belief that only physical health and activities influence the heart. However, a person’s mental health can also impact the heart’s condition. 

Negative mind-body connections accelerate heart diseases. Constant and long-term stress contributes to high blood pressure and circulation problems, which are common risk factors for CVD.  

Moreover, clinical depression increases the risk of a heart condition and negatively impacts existing ones. In fact, according to APA, while 20% of people experience depression at one point in life, the percentage increases to 50% among people with heart disease. 

Untreated depression can significantly increase the heart attack risk. Even up to ten years after the initial depressive episode, persons who are clinically depressed are twice as likely to have a heart attack. 

Nonetheless, depression works both ways.  

People who have had a heart attack are more likely to become depressed. Experiencing such a shock and the worry that another potentially more dangerous catastrophe could occur without warning only strengthens the feelings of anxiety and fear.  

In their research, Steward and Rollman found that the prevalence of depression among cardiac patients ranges between 20-30%. This percentage is at least double the prevalence of treatable depression among the population.  

Therefore, it is evident that mental health and cardiovascular conditions are closely related and equally affect one another. Consequently, people must take care of their mental health as much as they look after their physical well-being, and those with heart conditions must be especially wary of their mental wellness. 

Work-Related Stress & Cardiovascular Disease

Among the different types of stress, work-related tension is reaching an all-time high among workers. 

According to APA’s “2021 Work and Well-being Survey,” 71% of employees deal with workplace stress daily, but almost all US workers (94%) have experienced stress in the workplace at one time. 

The most significant work-related stressors are low salaries (56%), long working hours (54%), and lack of career growth opportunities (52%). 

With so many people being affected by pressure on the job, work stress and heart disease are inevitably connected. The research titled “Work Stress as a Risk Factor for Cardiovascular Diseasereviewed evidence from more than 600,000 employees in Europe, the USA, and Japan. The aim was to determine whether work stressors elevate the risk of health disease and stroke 

The conclusion was that workers exposed to work stressors have a 10-40% higher risk of CVD. Moreover, there is a close association between stress in the workplace and diabetes, which is a significant risk factor for heart problems.  

The Benefits of Cardiovascular Health Programs in Promoting Good Heart Health

With over 150 million people working in the US, workplaces offer a sizable audience for initiatives to promote good heart health. 

As reported by CDC, 80% of cardiovascular diseases and strokes are preventable. Therefore, cardiovascular health programs can go a long way in reducing the percentage of people affected by heart conditions. 

These programs have a holistic approach to reducing the risk of coronary issues. Namely, they aim to prevent significant risk factors, including tobacco use, obesity, hypertension, and diabetes. As such, not only do they reduce the risk of cardiovascular diseases, but they also improve the overall health and well-being of employees. 

In addition to improving workers’ physical and mental health, cardiovascular health programs also benefit employers. According to CDC’s data, heart diseases cost companies a massive amount of money. Preventing and decreasing the risk of CVD reduces the financial burden associated with the conditions.  

Therefore, by investing in wellness programs and reducing heart problems due to stress, organizations will save money that would otherwise be spent on lost productivity and absenteeism 


how can stress increase the risk for cardiovascular disease

As evidence suggests, stress can increase the risk of cardiovascular disease. However, the good news is that most heart issues can be prevented.  

People can avoid the most common risk factors by adopting a healthy lifestyle and changing habits and behaviors. Cardiovascular health programs in the workplace can support employees in their efforts to lead healthier lives.  

Written by Marija Petrushevska | Content Writer at Shortlister & Ivana Radevska | Senior Content Writer at Shortlister
Written by Marija Petrushevska | Content Writer at Shortlister & Ivana Radevska | Senior Content Writer at Shortlister