How Stress Affects Your Heart

SBM: how-stress-affects-your-heart

Kara A. Nishimuta, PhD – University of Kansas Medical Center; Abbey Collins, BA – North Carolina State University; Vanessa Volpe, PhD – North Carolina State University; Madeleine Hardt, MA – University of Missouri, Yale University; Allison Gaffey, PhD – Yale University, VA Connecticut Health System 

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A stressor is a perceived challenge or threat that prompts a mental and physical response. A stressor can last a short amount of time - for example, giving a public speech. A stressor can also be cronic, lasting much longer, such as caring for a loved one. Stress can affect your heart health and managing heart health can also be stressful.

When you experience stress, there are two body systems that respond. First, the sympathetic nervous system (responsible for “fight or flight”) responds within seconds. This system releases hormones such as epinephrine (adrenaline) into the body that quickly change your heart rate, breathing, and digestion, so you’re ready to respond immediately to the stressor. The second system, the hypothalamic pituitary adrenal axis, takes at least several minutes to respond, and involves the release of many other hormones, including cortisol. The primary purpose of cortisol is to make more energy available in your body.

The experience of stress is different for everyone, but people with heart health issues may feel stressed by some common experiences:

  • Information overload
  • Scheduling, coordinating, or following up with medical appointments
  • Medical diagnoses and test results - waiting for them, receiving them, understanding them, and considering how they might affect your life
  • Being in the hospital and having medical procedures
  • Getting and taking new medications or learning how to use new medical equipment or devices
  • Financial problems due to healthcare costs, missing work to attend medical visits, or having enough money or time to make healthy behavior changes
  • Caregiving for others while you’re experiencing your own health problems
  • Difficulty getting accommodations for your health to take time off from school or work
  • Feeling lonely or like people in your support network don’t understand what you’re going through, people treating you differently

You may have noticed symptoms that occur when you experience stress. These symptoms may be physical, emotional, and/or behavioral, and may change depending on the type of stressor. Some examples of each include:


  • Fatigue
  • Headaches
  • Difficulty sleeping
  • Chest pain/tightness or shortness of breath
  • Muscle tension or soreness
  • Upset stomach
  • Changes in appetite
  • Changes in sex drive/functioning
  • Sweating more
  • Shaking


  • Feeling overwhelmed
  • Worrying more than usual
  • Increased irritability or anger
  • Crying more or more easily
  • Being restless or fidgety
  • Trouble concentrating
  • A lack of motivation
  • Sadness, hopelessness, or depression


  • Eating more or less than usual
  • Drinking, smoking, or using other substances more than usual
  • Angry outbursts (e.g., yelling or snapping at people when you normally would not)
  • Exercising more or less than usual
  • Withdrawing from others

As you may have noticed, many symptoms of stress can overlap with cardiovascular symptoms you may have experienced. Stress can cause symptoms like chest tightness, shortness of breath, lightheadedness, and fatigue, all of which may also be caused by cardiovascular disease. If you’re unsure of the cause of symptoms like this, talk to your cardiologist about how you can differentiate between stress and cardiovascular symptoms.

Stress Management for a Healthy Heart

Managing your stress is crucial to protect your heart and prevent further psychological and physical health problems. There are several ways to manage stress and its effect on the heart. Below are some strategies to reduce the impact of stress symptoms on your body:


  • Seek a counselor for support, especially when the cause of stress cannot be eliminated.
  • Practice relaxation techniques such as meditation, muscle relaxation, and deep breathing.


  • Talk to a doctor about medication for anxiety and/or depression. Chronic stress can lead to depression and/or anxiety and, for some, these can be treated effectively with medication.
  • Chronic stress can lead to high blood pressure. Incorporating medications to reduce blood pressure can reduce the impact of stress on your heart.


  • Aim for seven to nine hours of sleep. This can improve your mood, mental alertness, energy level, and physical health.
  • Participate in regular exercise routines like yoga, a daily walk, or going to the gym.
  • Engage in self-care activities such as enjoying time outside, listening to music, eating healthy meals, napping, etc. These activities look different for everyone!


  • Spend time with friends and family. Having a support system and people you trust can help provide comfort and a sense of belonging.
  • Find a hobby that is a healthy distraction and something you look forward to.
  • Improve time management skills to ensure that you can balance life responsibilities while also finding time to rest and take care of yourself.
  • Chronic work stress can harm your health. For some, changing jobs or finding a new job can help reduce stress symptoms.

"How Stress Affects Your Heart " is second in a series of five articles on how heart health and mental health are related. 

Learn More:

Anxiety and Heart Disease: Johns Hopkins Medicine

Healthy Living: American Heart Association

Heart Disease and Mental Health Disorders: CDC

How to Manage Stress with Mindfulness and Meditation: Mindful

What is Stress Management?: American Heart Association

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