Stress in life is inevitable. Try as we may, the average person can't eliminate it entirely — after all, it's what makes us successful in so many of life's endeavors, say experts. But unbridled, long-term tension has consequences, including a heightened risk for heart disease. In fact, a recent study found that chronic stress from repeated criticism or arguments in relationships increases the risk of heart attack by 34 percent. “Stress doesn't always have a place on the podium as a risk factor for heart disease, but it's important,” says David Sabgir, MD, a cardiologist at Riverside Methodist Hospital in Columbus, Ohio. Unchecked, it can cause you to fall back on or develop bad habits — like an unhealthy diet or poor sleep and exercise — which lead to precursors of heart disease, such as high blood pressure and abnormal cholesterol levels, he says.

How exactly does stress affect your heart? Consider this typical pattern: When you encounter something stressful, be it a tense work situation or a near-crash, your adrenal glands release cortisol, a stress hormone, which raises your blood pressure and quickens your heartbeat, sending you into “fight-or-flight” mode. Although this is a normal response to a stressful situation, it's not normal for the body to remain stuck there. Elevated cortisol levels over the long term lead to inflammation — and inflammation of any kind in the body has been linked with an increased risk of heart disease.

Take our quick quiz (“Is Stress Harming Your Heart?” at right) to help determine if your stress levels are dangerous to your heart. If they are, then definitely follow these six heart-smart, stress-less strategies from the experts. Even if you ace the test, everyone gets thrown a few curve balls, so learning techniques to dodge them is bound to come in handy.

  1. Sweat it out

    When work deadlines pile up or the kids are sick, workouts quickly slip off the to-do list. Listen up: Crazed days are when you need to lace up your shoes more than ever, because exercise is a well-proven stress reliever. “Even something as simple as walk-ing for half an hour will help ease your stress and reduce your heart disease risk,” says Brian Kahn, MD, a cardiologist at Mercy Medical Center in Baltimore. Not only does regular exercise strengthen your heart and lower cholesterol, but a 2007 study found that exercise can reduce inflammation that can contribute to heart disease. Aim for at least 30 minutes of moderate cardiovascular exercise, like walking or biking, daily.

  2. Don't skip breakfast

    When you're overworked, a wholesome breakfast might not seem important. But starting your day on an empty stomach can start a serious stress cycle, says Paul Ratté, ND, a naturopathic physician at Northwestern Health Sciences University in Bloomington, Minnesota. Here's why: When your blood sugar is low — which happens when you skip a meal or don't eat the right foods to sustain energy — your body reacts by releasing cortisol, leaving you jittery and scattered. Don't worry about extensive prep or perfecting your omelet: The best on-the-go breakfast is probably already in your fridge, says Ratté. “I tell people to eat their leftovers from last night's dinner for breakfast. A turkey sandwich is the ideal breakfast because it has a mix of protein, carbs, and fat for sustained energy,” he says.

  3. Take 10

    “People hear the word meditation and they think they need to go to a class, sit in the lotus position, and say ‘om,’ but meditation can mean different things to different people,” says Ratté. Whatever gets your mind off your day — a brisk walk around the block, flipping through a magazine, going window-shopping, or relaxing in a bath with essential oils — can reduce stress in the same way as traditional forms of meditation. When you encourage your mind to relax, your body allows itself to enter the parasympathetic response — the opposite of the fight-or-flight response. Your body gets the signal that it's OK to repair itself: Heart rate and blood pressure drop, your immune system becomes more active, digestion smoothes, and all of this helps stress levels decrease. “When we're overstressed, we're walking around in such a semiconscious state, we're just going through the motions,” says Ratté. “By taking a break to step outside of your life and be in the moment, you're building your resilience to stress, which will make you better able to manage it.”

  4. Let go of outcomes

    Did that car just cut in front of you? Is the line out the door at your favorite café? You may not be able to control the other driver or how many people are in front of you waiting for their caffeine fix, but you can control how you respond to the situation, says stress-management expert Debbie Mandel, author of Addicted to Stress (Jossey Bass, 2008). A 2004 study found that anger and hostility were related to higher levels of C-reactive protein, which is produced by the liver; high blood levels of this substance are associated with narrowing of the arteries. “Try reframing your day,” says Mandel. Rather than honking your horn and yelling at the car in front of you, consider that person might be rushing to the hospital for an emergency. Instead of thinking of how little work you're getting done waiting in line, stay positive by rehearsing the presentation you're about to give or brainstorming birthday gifts for your husband. Taking this approach will get you into the habit of keeping your cool during stressful times.

  5. Sleep

    Getting enough sleep on a consistent basis is crucial to numer-ous organs, including the heart. “The less sleep you get, the more activated your sympathetic nervous system gets, which constricts blood vessels and increases blood pressure,” says Sabgir. Lack of sleep also leads to elevated cortisol and insulin levels, and promotes inflammation, all of which increase heart disease risk. A 2003 study published in the Archives of Internal Medicine found that getting five hours or less of shut-eye nightly can raise heart disease risk by up to 39 percent, and that six hours elevates the risk by 18 percent. (A minimum of eight hours is the magical heart-disease-lowering number.) “Some people say, ‘Oh, I only need four hours of sleep,’ but that's not true. Most people need at least seven hours of sleep,” says Sabgir.

  6. Talk it out

    Interpersonal conflicts can raise cortisol levels and put stress on your heart, so don't let anger or frustration fester, say experts. “People often expect their partners to be mind readers and anticipate their needs, but if you're upset about something, the other person often doesn't even know,” says Mandel. Talk with your partner about what's really bothering you: Rather than silently fuming that your partner never does the dishes, calmly — and without blaming — ask him or her to pitch in.

Megan McMorris is a freelance writer based in Portland, Oregon. For stress relief, she would like to perfect the art of mindful meditation.

Heart disease defined

Heart disease is caused by plaque buildup that narrows the blood vessels or blocks the coronary arteries that supply blood and oxygen to your heart. Blood supply diminishes, causing chest pain, shortness of breath, or — in severe cases — heart attack.


Is stress harming your heart?

  1. You're on your way to work when you hit a traffic jam. What do you do?

    a. Honk your horn and grit your teeth.

    b. Use the time to check email on your iPhone or Blackberry.

    c. Sit and listen to music, using the time as a break before your busy day.

    Stress-o-meter says: A big source of stress is how you handle it, explains Paul Ratté, ND, a physician at Northwestern Health Sciences University in Bloomington, Minnesota. If you answered C, you've learned to let go of things you can't control. By using the time to be in the moment (rather than multitask), you're training your body to remain calm during stressful moments.

  2. Do you often feel fatigued during the day?

    a. Yes
    b. No

    Stress-o-meter says: While heart disease is a silent condition because symptoms like high blood pressure and high lipids don't have warning signs, stress can cause a host of physical symptoms, says Christie Ballantyne, MD, director of the Cardiovascular Disease Prevention Center at Baylor College of Medicine in Houston. Physical side effects of stress include excessive fatigue, tremors, back pain, headaches, diarrhea or constipation, weight gain or loss, and insomnia.

  3. You go to the grocery store and forget your grocery list. Can you remember it off the top of your head?

    a. Sure. You just wrote everything down earlier in the day, so it's fresh in your mind.

    b. No. You keep walking the same aisle, forgetting what you were there for (is it coffee filters or coffee that you need?).

    c. You can remember almost everything, but have to make a second trip to the store for toilet paper.

    Stress-o-meter says: If you answered B, you may have overwhelming stress in your life. Mental symptoms of stress include difficulty concentrating, forgetfulness, indecisiveness, and worrying, says Ballantyne.

  4. True or false: You're eating more or less than usual lately.

    a. True
    b. False

    Stress-o-meter says: Changes in your eating, sleeping, and exercise schedule can all be signs that stress is interfering with your life, as can picking up nervous habits like nail biting and pacing, says Ballantyne.

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