People who think stress is affecting their health may be setting themselves
up for a heart attack, a new study contends.
The researchers found that these people had double the risk of a heart attack
compared with people who didn't think stress was harming their health.
"People's perceptions about the impact of stress on their health are likely
to be correct," said study author Hermann Nabi, a senior research associate at
the Centre for Research in Epidemiology and Population Health at INSERM in
"They may need to take action when they feel that it is the case," he
These findings have both clinical and theoretical implications, Nabi
"From a clinical perspective, they suggest that complaints of adverse impact
of stress on health should not be ignored in clinical settings as they may
indicate increased risk of developing coronary heart disease," he said.
From a theoretical perspective, the findings imply that the perceived impact
of stress on health is a valid concept that should be considered in future
studies aimed at examining the association between stress and health outcomes,
Dr Gregg Fonarow, a professor of cardiology at the University of California,
Los Angeles, said that "stress and reactions to stressful situations have been
associated with increased risk of cardiovascular disease in many studies".
However, few studies have looked at whether an individual's perception of
stress is associated with cardiovascular outcomes, he said.
And it's not clear if reducing stress would affect the risk for heart attack,
"Further studies are needed to determine whether stress reduction or other
risk reduction strategies can reduce cardiovascular events in men and women who
perceive they are under stress that is adversely impacting their health," he
Dealing with stress
For the study, Nabi's team collected data on more than 7 000 men and women
who took part in the Whitehall II study, which has followed London-based civil
servants since 1985.
Participants were asked how much they felt that stress or pressure in their
lives had affected their health. Based on their answers, they were placed into
one of three groups: "not at all," "slightly or moderately," or "a lot or
Participants were also asked about their levels of stress and other lifestyle
factors such as smoking, drinking, diet and physical activity.
The researchers also collected medical information, such as blood pressure,
diabetes status and weight, and other data, including marital status, age, sex,
ethnicity and socioeconomic status.
Over 18 years of follow-up, there were 352 heart attacks or deaths from heart
After taking all of these factors into account, the investigators found those
who said their health was a "lot or extremely" affected by stress had more than
double the risk of a heart attack compared with those who said stress had no
effect on their health.
After further adjustments for biological, behavioural and other psychological
risk factors – including stress levels and measures of social support -– the risk
wasn't as high. But it was still a lot higher (49% higher) than among those who
said stress didn't affect their health, the researchers noted.
While the study found an association between perceived levels of stress and
heart attack, it did not prove cause-and-effect.
Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center
in New York City, offered some tips on dealing with stress.
The stress response is not only a mental reaction to a situation, but a
physiological reaction, she explained.
"Acute and chronic stress over time can make us sick. Our perception of how
that stress affects our health may be an additional stressor biochemically,
psychologically and physiologically, creating a feedback loop that results in
increased physical distress and disease," Heller said.
Managing stress does not mean ignoring it, she said. "Working with a
qualified mental health professional who specialises in cognitive behavioural
therapy can be very helpful. In lieu of that, there are some things you can do
on your own."
- Take several slow deep breaths periodically throughout the day. Deep
breathing can shift the body out of the fight-or-flight response.
- Exercise regularly. Cardiovascular exercise teaches the body how to handle
the physiological effects of stress. It also helps reduce anxiety and
- Eat as healthfully as possible. Chronic or acute stress may trigger the
desire to dive into high-calorie comfort foods. However, after an initial flash
of relief, you will tend to feel lethargic, fatigued and possibly worse than you
- Identify stressful triggers, and create a plan to help you cope.
- Instead of stressing about your health, be proactive and find ways to
improve it. If you have high blood pressure, learn how to lower the sodium in
your diet. Start walking a few days a week to strengthen your heart and help
For more on stress and your heart, visit the American