Perceived Stress Increases Risk of Heart Disease, Study Finds; Plus How to Handle Stress

Perceived Stress Linked to Higher Risk of Heart Disease, New Study Finds (Image courtesy of Wikipedia Commons)A new analysis of studies involving 118,696 participants, conducted by Donald Edmundson, PhD, a professor at Columbia University Medical Center, and colleagues, has found that self-reported perceived stress was associated with a 27% higher risk of coronary heart disease than was experienced by those who reported not feeling stressed.

The new study was published on September 12, 2012 in the online edition of the American Journal of Cardiology.

“Most studies examining potential associations between psychological factors and cardiovascular outcomes have focused on depression or anxiety. The effect of perceived stress on incident coronary heart disease (CHD) has yet to be reviewed systematically,” the authors stated in an introductory abstract of the new study. The researchers set out to do just that.

The new study is one of the first to link self-perceived stress with a higher risk of heart disease.

According to the National Institutes of Health, coronary heart disease is a condition in which a waxy substance called plaque builds up inside the coronary arteries, which can narrow or block the flow of oxygen-rich blood to the heart, leading to heart attacks.

The National Institutes of Health reports that coronary heart disease is the number one killer of both men and women in the United States; more than 400,000 people die from this condition each year.

The good news is that you can learn to recognize the symptoms of stress, and there are known steps you can take to reduce or cope with stress, according to experts.

The New Study; Methodology

Through a search of scientific literature, the researchers isolated for analysis six previous studies involving a combined total of 118,696 participants. These studies “measured perceived stress [of the participants] with validated measurements and nonvalidated simple self-report surveys.” Some of the studies used a questionnaire measuring how frequently or how severely the participants felt stressed out. Others asked for a yes or no response to questions about whether the participant had felt stressed.

In each of the studies, none of the participants had coronary heart disease at the beginning of the study.

Over follow-up periods ranging from 3 to 21 years, the researchers tracked how many of the study participants received a diagnosis of coronary heart disease, or experienced a hospitalization or death due to coronary heart disease.

The researchers compared the extent to which cardiovascular disease incidents were experienced over the study follow-up periods by those participants who reported high self-perceived stress levels versus the participants who reported low self-perceived stress.

“We conducted a systematic review and meta-analysis of the association between perceived stress and incident CHD [coronary heart disease],” the authors said.

Findings; Conclusions of the Study

Based on their analysis of the combined data from the six studies, the researchers found that people who reported feeling high stress were 27 percent more likely to be diagnosed with coronary heart disease, be hospitalized with the condition, or die from it during the study follow-up period than were those who reported low stress or no stress.

Dr. Edmundson, the study’s corresponding author, told Reuters Health that the increase in heart disease risk related to stress is equivalent to that associated with smoking five cigarettes a day.

One possible explanation he gave as to why stress may lead to higher risk of heart disease is that stress raises the levels of certain hormones in the blood which can negatively affect the heart.

Other experts pointed out to Reuters Health that people who feel stressed may also tend to behave in less healthy ways, such as smoking, making unhealthy dietary choices, or being inactive physically. These unhealthy lifestyle factors may increase the risks of cardiovascular disease.

Dr. Edmundson emphasized that “people can take steps to reduce their stress, such as exercise, yoga and meditation.”

“Good old-fashioned exercise, good old-fashioned stress reduction techniques, are probably – the study hasn’t been done yet – but are probably going to be good for healthy people to offset their risk of heart disease going forward,” Dr. Edmundson said.

How to Recognize, Handle and Reduce Stress

What are the Signs and Symptoms of Stress?

According to a webpage on Manage Stress provided by, a public health consumer resource provided by the U.S. Department of Health and Human Services (HHS), some of the signs and symptoms of stress include:

  • Feeling:
    • Worried
    • Angry
    • Irritable
    • Depressed
    • Unable to focus; or
  • Experiencing physical symptoms including:
    • Headaches
    • Back pain
    • Problems sleeping
    • Upset stomach
    • Weight gain or loss
    • Tense muscles
    • Frequent or more serious colds

Mental Health America, a nonprofit organization dedicated to promoting mental health, provides a Stress Screener Quiz to help you assess and understand the level of stress you are feeling in your life.

How to Manage and Reduce Stress? suggests nine steps you can take to prevent and manage stress:

  1. “Plan your time.
  2. Prepare yourself. Prepare ahead of time for stressful events
  3. Relax with deep breathing or meditation.
  4. Relax your muscles. Try stretching or taking a hot shower to help you relax.
  5. Get physically active. “Aim for 2 hours and 30 minutes a week of moderate aerobic activity, like walking fast or biking. Be sure to exercise for at least 10 minutes at a time. Do strengthening activities – like sit-ups or lifting weights – at least 2 days a week.”
  6. Eat healthy. “Give your body plenty of energy by eating vegetables, fruits, and protein.”
  7. Drink alcohol only in moderation — [or not at all]. “Don’t use alcohol and drugs to manage your stress.”
  8. Talk to friends and family. “Tell your friends and family if you are feeling stressed. They may be able to help.”
  9. Get professional help if you need it.”

More detail about these tips is found under Take Action on‘s Manage Stress resource.

The nonprofit organization, Mental Health America, also provides tips on how to manage and reduce stress:

  1. Connect with others
  2. Stay positive
  3. Get physically active
  4. Help others
  5. Get enough sleep
  6. Create joy and satisfaction
  7. Eat well
  8. Take care of your spirit
  9. Deal better with hard times
  10. Get professional help if you need it.”

The Substance Abuse and Mental Health Services Administration (SAMHSA) of HHS provides a tool to help you find a mental health facility in your area where you may be able to get professional help.

In an article entitled “Simplify your life to reduce stress,” the Mayo Clinic provides other tips for reducing stress. These include suggestions such as: reduce the clutter in your environment, switch off the media, clear your calendar, and stop multitasking.

For other resources on handling stress, including alternative therapies and coping suggestions, see MedlinePlus, a source of consumer health information provided by the National Library of Medicine, part of the National Institutes of Health.

More Information

See related HelpingYouCare® reports on:

Is Stress at Work Adding to Your Stress as a Family Caregiver?

Can a Smile Reduce Stress?

Optimism & Positive Outlook May Help Prevent Heart Attack, New Study Finds

New Survey Links Caregiver Stress to Unhealthy Behaviors & Chronic Disease

See also the HelpingYouCare® resource pages on OurTimeForCare™ – Caregiver Self-Care, Stress Management, Inspiration & Humor, including:


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