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Reviewed by the Faculty of Harvard Medical School


Harnessed constructively, stress can fuel creativity and personal accomplishment. But when unmanaged and out of control, stress takes a terrible toll on your body. Research seems to suggest that your personality, the stressful events in your life and your body's physiological reaction to stress can increase your risk of heart disease. The stress/heart disease connection, however, is still a theory. Stress is chalenging to study, because it's difficult to measure the psychological and physical responses to stress.

But this much is clear: When an event is perceived as a threat — whether a deadline, a divorce, stalled traffic or misplaced keys — the body harks back to that ancient "fight-or-flight" response that once meant life or death. First, the stress hormones — adrenaline and cortisol (made by the adrenal glands) — flood the body, increasing the heart's need for oxygen as it prepares for vigorous action. Heart rate and blood pressure increase. Blood vessels in your skin constrict. Muscles tense and blood sugar levels increase. The tendency for blood to clot increases and the body's cells pour stored fat into the bloodstream. Add it all up and it puts additional strain on the heart and artery linings. When the stress resolves, the body returns to normal. However, many modern stressors are ongoing and do not resolve quickly.

People who already have coronary artery disease may experience chest pain (angina) as a pounding heart and rising blood pressure increase the heart's need for oxygen. And the increased tendency for the blood to clot may predispose certain people to develop a clot in their coronary arteries, causing a heart attack.

Blowing up now and then isn't harmful. But if your emotional responses get stuck in a constant state of irritation and anger, your physical stress responses also stall in overdrive, which raises blood pressure, constricts blood vessels and pours out a constant flood of stress hormones. Over time, as the body becomes less sensitive to cortisol and the other stress hormones, the adrenal glands respond by increasing production, even though the original trigger is no longer there.


Although you can't control some of the events that cause stress, you can control how you manage it. The first step is to recognize the symptoms of stress, such as muscular tension, headache, insomnia, irritability and changes in eating habits. Other warning signs include apathy, mental or physical fatigue and frequent illness. To determine whether you may have aspects of Type A personality (which are particularly harmful), ask yourself these questions:
  • Are you generally cynical or mistrustful of others? For example, do you distrust others to do their jobs properly and feel the need to check up on them?
  • Do you wish bad things to happen to people you believe don't work as hard as you?
  • Do you get very irritated or angry when people leave a mess in your way — leaving dishes in the kitchen sink or forgetting to mail out a report — or interfere with your daily schedule?
  • Do you mistrust people who say they want to help you?
  • Do you honk your horn repeatedly when the car in front doesn't move the instant the light turns green?

If you answer yes to any of these questions you may benefit from these stress reduction strategies:

Calm down, live longer

To lower your stress levels, try a combination of techniques, designed to relieve tension, help you avoid potentially stressful situations and, above all, change the way you view events.

Duke University stress researcher Redford Williams, author of Anger Kills, emphasizes asking yourself whether what you're getting all worked up about is really important in the grand scheme of things. How much time will you really save even if you could make the elevator come faster or the supermarket checkout speed up? Figure it out, then drop it. If on the other hand, the situation does deserve a response (someone has cut in front of you on the bank line), it's appropriate to assert yourself. But forget about murder. It's your body that will pay.

Avoid the stimulants

While smoking may have an immediate effect of calming your nerves, the effect is only short-term. Nicotine actually is a stimulant, revving up the nervous system. The building addiction it causes serves to leave you excited until your next fix. Caffeine may also add to agitation and irritability.

Try exercise

Regular aerobic exercise can reduce the level of stress hormones in your blood. Even a brisk walk can help lower stress hormones and dispel anger. Most experts recommend daily exercise for at least 30 minutes, but even exercising three times a week can offer benefits.

Take time to de-stress

Some experts recommend joining a class to learn meditation, yoga, biofeedback or other stress-reduction techniques. But even just taking some time each day to unwind by listening to music, reading or gardening can also help. The key is to find some activity that helps you get your mind off your worries.

Keep a stress diary

Write down the occasions that were stressful to you. Jot down the time of day and the circumstances that led to it, then try altering or avoiding these circumstances. Obviously, if you are stressed by your job, quitting may not be an option, but you can do things that may help. It also helps to make a list of the tasks you have to complete in a day and check them off as you go. If you find you are stressed before a meeting or whenever you are around a specific person, such as your boss, try one of the relaxation techniques described above.

Use a quick fix

A host of stress reduction strategies can be completed in just a few seconds:

  • Cleansing breath. When you find yourself getting worked up over an event, stop and take a deep breath. Hold it for a few seconds and then let it out v-e-r-y s-l-o-w-l-y. As you blow out, imagine blowing all the tension from your body.
  • Relaxing postures. Sit anywhere, even at your desk at work. Relax your shoulders so that they are comfortably rounded. Allow your arms to drop by your sides. Rest your hands, palm side up, on top of your thighs. With your knees bent, extend your legs and allow your feet, supported by your heels, to fall gently outward. Let your jaw drop. Close your eyes and breathe deeply for a minute or two.
  • Passive stretches. It's possible to relax muscles without effort; gravity can do it all. Start with your neck and let your head fall forward to the right. Breathe in and out normally. With every breath out, allow your head to fall more. Do the same with your shoulders, arms, and back.
  • Imagery. Find a comfortable posture and close your eyes. Imagine the most relaxed place you've ever been. It may be a lake, a mountain, a beach or anything. Try to imagine all five senses.
Last updated May 30, 2011