How Stress Hurts Your Heart Health — and What You Should Do About It

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February 3, 2022


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This post is available in: Spanish

“Relax.” That is probably the last piece of advice you want to hear if you are stressed out. That single word can cause your blood pressure to spike and increase — not decrease — your anxiety, agitation or anger.

Still, it is important for your health to seek solutions if you are experiencing a lot of tension, frustration or worry. Stress isn’t just a state of mind; it causes physiological responses that can have serious long-term repercussions on the body, particularly your cardiovascular health.

“Depression, anxiety, stress — these are factors we know cause inflammation over time,” says cardiologist Paula Montana De La Cadena, M.D. of Miami Cardiac & Vascular Institute, part of Baptist Health South Florida. “Inflammation can contribute to atherosclerosis and increase the risk for stroke, heart attacks, heart failure, even sudden death.”

Understanding the Stress Response


Cardiologist Paula Montana De La Cadena, M.D. of Miami Cardiac & Vascular Institute.

Stress is a natural neurological response to a threat or danger. During stressful events, your brain signals your body to release hormones, giving you a burst of “fight-or-flight” energy to fuel your response. An example is the jolt of epinephrine, also known as adrenaline, that you get when a car suddenly cuts you off on the highway; almost without thinking, you hit the brakes to avoid an accident.

That reflex is the result of a complex cascade of hormones orchestrated by the brain, which is hard-wired for your self-preservation. When the threat recedes, the brain is designed to put the brakes on the release of these hormones. But not all triggers pass so quickly. Continuous stress from work, family or financial concerns, anxiety or depression can keep the neurological response chronically activated, much like a motor that is idling too high for too long.

 “In the long run, if you have prolonged exposure to elevated epinephrine and cortisol levels, it can be very harmful to the cardiovascular system,” Andrea Vitello, M.D., a cardiologist at Miami Cardiac & Vascular Institute and member of the Institute’s prevention and risk reduction team, explained recently on an episode of Baptist Health’s podcast, HealthTalk. “Cortisol raises blood sugar and increases blood pressure, and epinephrine raises heart rate. Those combination of factors — elevated blood sugar, elevated blood pressure and elevated heart rate — can be very detrimental to the cardiovascular system.”

Over time, stress can damage blood vessels and raise the risk of heart attacks or strokes. Studies show ongoing stress can also affect sleep, contribute to unhealthy eating and drinking, and exacerbate mental health issues — all of which also can impact physical health.

When Stress is a Problem


Andrea Vitello, M.D., a cardiologist at Miami Cardiac & Vascular Institute and member of the Institute’s prevention and risk reduction team.

According to the U.S. Department of Health and Human Services, women are more likely than men to report symptoms of stress. Experts do not fully know the reason for the difference, but it may be related to how men’s and women’s bodies process stress hormones.

Dr. Montana De La Cadena says she has observed that stress can be a challenge for some of her female patients, who shoulder a lot of responsibility. “We see women who are juggling family, work, maybe caring for a spouse or parents. They tend to forget to take care of themselves,” she says.

Regardless of gender, everyone should take steps to reduce stress, she says. “I always encourage exercise. To me, exercise is a great therapy for many things — not only for cardiovascular health. It boosts your immune system and can help improve mental health,” Dr. Montana De La Cadena says. “I also encourage relaxation such as yoga and mediation, as well as good sleep hygiene.”

For some patients, however, that might not be enough.  “When I identify that stress is interfering with their life, I suggest they seek professional help — whether psychology or psychiatry. All of us at sometime need help, and there is nothing wrong with that.”

A good therapist can help you identify the source of your stress and find strategies to address it, Dr. Montana De La Cadena says. In some cases, medication might be beneficial, which would require the guidance of a physician. “Severe depression or anxiety require treatment, period. You won’t be able to do it by yourself.”

If you don’t already have a relationship with a mental health professional, Baptist Health’s Care on Demand is one place to turn. The telehealth service provides immediate virtual access to licensed doctors and experts without leaving home by using a smartphone, tablet or computer.

Why You Should Seek Solutions

Allowing stress to go unchecked does not make you a hero. Even if you think you can deal with it mentally, your body is unconsciously responding — with long-term implications.

Dr. Montana De La Cadena notes that in these busy, complicated times, it’s important to prioritize your own health by addressing factors that can be detrimental.

“People need to understand 80 percent of cardiovascular diseases are preventable,” she says. “The sooner you start, the more significant the impact will be, especially when it comes to lifestyle modification.”

Advises Carmen Barresi, a licensed mental health counselor with Baptist Health’s Community Health & Wellness, “A good place to start is to acknowledge how you are feeling.”

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