Stress and heart attacks are often thought to go hand-in-hand, and you may be concerned that being stressed out can trigger a cardiac event. While every time you are stressed, you aren’t going to have a heart attack, there’s an important mind-body connection to understand. So, can stress cause a stroke or heart attack? Let’s take a look. 

Can Stress Cause a Heart Attack?

We all experience challenging things, and it’s impossible to avoid every stressor. Stress alone doesn’t directly cause a heart attack in the way that having a clogged artery can, but it can still increase your risk. 

Ongoing stress can increase your vulnerability to having a cardiac event, especially if you’re already dealing with other silent risk factors, such as: 

• Having pre-existing medical conditions, such as prediabetes or diabetes
• Metabolic syndrome
• Inflammatory conditions like psoriasis
• Being overweight or obese
• High blood pressure
• Elevated blood lipids 
• High inflammatory markers, like high-sensitivity C-reactive protein

Research shows that intense emotional stress, such as grieving the loss of a loved one or enduring the consequences of a natural disaster, can trigger heart attacks. One example is Takotsubo cardiomyopathy, also called broken heart syndrome, which mimics a heart attack and causes temporary heart muscle dysfunction, often following extreme stress. 

Many people live with risk factors, such as silent plaque buildup in their arteries, which do not cause obvious symptoms. When you’re also carrying around chronic stress, this encourages inflammation, raises blood pressure, and makes your blood vessels more susceptible to damage. All of these factors working together can eventually lead to a heart attack.

For example, I once had a client who experienced a stressful event and then experienced a heart attack. But after looking at her cardiac labs, it was apparent that there had been a lot brewing in her arteries that was ignored long before the event. 

In a 2021 analysis in JAMA, researchers examined over 900 patients with underlying heart disease. The goal was to understand how blood flow to the heart responds to mental and emotional stressors. 

The participants underwent standardized stress tests, and the researchers measured the blood flow to their hearts. Mental stress took a large toll on the heart during stress tests. Those faced with mental stress had a higher likelihood of having a heart attack. They were also more likely to die of cardiovascular disease in the years following the stressful experience.

Bottom line: While stress may not be the root cause of a heart attack, it can be the last straw that breaks the camel’s back.  

What Happens in the Body During Stress

A physiological response takes place in your body every time you’re up against a stressor. This happens to protect you from harm.

The stress response is regulated by the hypothalamic–pituitary–adrenal (HPA) axis. It’s connected to the endocrine (hormone) and central nervous (brain and spinal cord) systems, which work together to adjust the balance of hormones. 

One stress hormone is cortisol, which is released when the HPA axis is activated. Cortisol sends more blood to your muscles, increases your blood sugar, and raises your blood pressure as part of your “fight or flight” preparation. There’s a negative feedback loop in which high cortisol levels tell the HPA axis to stop producing it when the stressful event has passed.

Is it Stress or a Heart Attack?

Most of us describe stress as feeling overwhelmed or struggling to cope with mental pressures. It may also have physical manifestations. 

Symptoms of stress can include: 

• Trouble falling asleep and/or disrupted sleep
• Fatigue or low energy
• Irritability and little patience
• Reduced libido
• Low mood

Acute vs. Chronic Stress

Acute stress is short-term and might even be described as exhilarating or helpful. This might be something like preparing yourself to go on a rollercoaster ride or give a speech. Acute stress comes and goes without significantly impacting your health.

Chronic stress is long-term and ongoing. For example, working a job or in an environment you really dislike, or being in a toxic relationship, can induce chronic stress. This stress can take a toll on your physical and mental wellness, including the health of your heart.

Prolonged stress doesn’t feel good, nor does it have any health benefits. While cortisol is helpful in the short term, it’s not meant to remain elevated. When it’s triggered over and over again, this can adversely affect heart health.

Chronic stress can raise blood sugar levels as well as the release of insulin. Over time, this can promote insulin resistance. Notably, 70% of people who have heart attacks are insulin resistant. 

Other long-term effects of stress can include inflammation, increased blood pressure, and reduced blood flow to your heart. This mix of factors can increase your risk of a heart attack.

How to Manage Your Stress and Protect Your Heart

Stress has a snowball effect. When you’re under stress, your sleep is affected, you’re less likely to exercise, and your nutrition may become less of a priority. You are often just functioning in survival mode. Identifying when stress is present and what’s triggering it can help you utilize management tools that work for you. Below are some everyday habits that can help. 

Make Brain and Heart-Healthy Nutrition Choices

Science-based nutrition is your primary tool when it comes to preventing and managing cardiac conditions, even managing stress. A healthy diet pattern means eating mostly minimally processed and whole foods, including fruits, vegetables, nuts, seeds, legumes, whole grains, and lean proteins, while limiting or avoiding ultra-processed foods and sugary beverages can also impact your mental health and help you manage stress better. 

Designing plates in a way that meets all of your nutrient needs in adequate amounts for you is key can help reduce inflammation, which can protect brain health, helping you better deal with stress. This also supports your immunity, arterial health, blood pressure, blood sugar, and blood fats. Eating a variety of the nutrient-dense foods mentioned above also helps ensure you’re getting antioxidants, which help protect your cells from oxidative stress that causes damage and disease.

If you need help designing a personalized targeted nutrition plan for you, work with a registered dietitian who specializes in heart disease.

Other Important Everyday Habits

• Get enough (quality) sleep. Not getting the recommended 7-9 hours can promote elevated cortisol. Create a more sleep-promoting space, adhere to a regular sleep-wake schedule, and avoid screens near bedtime. Blue light emitted from technology can interrupt the circadian rhythm. 
• Rest and unplug. We live in an on-the-go moment that’s easy to get caught up in. Instead, try to schedule rest as part of your regular routine. Perhaps this looks like taking space to meditate first thing in the morning or sitting outside on your patio in the evening. Rest is healing and can help your body relax. 
• Stay active. Aim for at least 150 minutes of moderate-intensity exercise per week, which might include a combination of jogging, playing tennis, swimming, or dancing. Resistance training is particularly beneficial for heart health, as studies show it can help increase exercise tolerance and reduce high LDL, lowering cardiovascular mortality by 40%.
• Avoid risky substances. Don’t smoke or consume alcohol excessively. Vapors from smoking can contribute to lower HDL, higher LDL, a higher risk of blood clots, and damage to blood vessels and arteries. Excessive alcohol can damage the structure and function of the heart. 
• Get support. It’s okay to have time alone, but we were never meant to do life in isolation. Research shows that the support of a community is critical to our longevity, and most of us could benefit from speaking to a therapist. Struggling with a medical diagnosis can be overwhelming and trigger health anxiety, and counseling can help. 

Stress and Heart Attack Takeaways

Can stress cause a heart attack? Not directly, but it can be a significant piece of the puzzle, especially when other risk factors are present. Understanding your stressors and how they impact you and adopting effective management tools, are crucial. 

If you want to take a proactive approach to reduce your risk of a heart attack and optimize your heart function, consider joining my Optimize Group Program. You can also schedule a complimentary 15-minute discovery call first here. I’d love to help you!

Sources

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