Go Red! The Stress-Healthy Heart Connection.

Simple Steps to Reduce Stress & Your Risk of Heart Disease.

Heart disease is the leading cause of death in the United States, and Congress has deemed February “American Heart Month.”  The American Heart Association also has a particular focus on Heart Disease in Women in February with it’s Go Red Campaign. So let’s talk about the Stress-Heart Disease Connection.


Heart disease is the number one killer of men and women in the U.S. Cardiovascular (Heart) Disease (CVD) is an underlying cause of death for approximately 36  percent of all  deaths;one of every 2.8 deaths in the United States. Nearly 2,400 Americans die of CVD each day, an average of one death every 36 seconds. CVD claims more lives each year than cancer, chronic lower respiratory diseases, accidents and diabetes mellitus combined. 

Here are the medical problems the American Heart Association includes in it’s definition of cardiovascular disease. High blood pressure, coronary artery disease (abnormal heart blood vessels), heart attacks, angina (chest pain due to coronary artery disease), and heart failure.  You probably know someone in your family with at least one of these disorders. Cardiovascular disease is at epidemic proportions!

It’s not a coincidence we are experiencing a concurrent epidemic of STRESS and  Cardiovascular disease in America!  I see patients with stress related problems in my Emergency Medicine practice in the ER everyday. You don’t have to be a statistic.

Today more than ever, the cornerstone of reducing YOUR personal risk for heart disease is getting a better handle on the stress in your life. 

Is there proof that stress causes heart disease?  There are some tough questions about stress and heart disease. Overall scientists have concluded that stress contributes to adverse cardiac events and more importantly creates a setting that makes the heart more at risk for problems.  That is not to say that “ stress causes heart disease” …. that simplistic notion would be the same as saying high cholesterol causes heart disease.  It is safe to say, stress is an independent risk factor for heart disease.


The Inter heart study ( was the first well designed study that investigated the relationship of chronic stressors to the incidence of heart attack. They evaluated 25,000 people from 52 countries. Stress was defined as feeling irritable having anxiety or sleep disturbances as a result of conditions at work or at home. They controlled for age country of origin and even smoking. 

Here’s what they found. Those who reported permanent stress at work or at home have greater than 2.1 times risk for the development of a heart attack. 

You might ask how important is stress in comparison to a more traditional risk factor like elevated cholesterol? If you use the risk assessment that has been established by the Framingham study which is the gold standard for assessment of cardiac risk,  Relative risk of total cholesterol between 200 and 239 or 1.3. For total cholesterol levels greater than 240 the relative risk is approximately 1.9. When looking at many of the stress of studies that have been reviewed most recently by Dr. Dimmesdale reported in the American College of Cardiology  that stress increases the risk of heart disease in a manner comparable to or steeper than the risk rating of elevated cholesterol.  (

What does this mean for you on a day to day basis?  The heart and blood vessels are particularly sensitive to acute and chronic stress. With every beat, the heart not only pumps blood, but transmits complex patterns of neurological, hormonal, pressure and electromagnetic information to the brain and throughout the body. The heart is uniquely positioned as a powerful communication hub that connects the body, mind, emotions, and spirit.  There is an elaborate feedback network of hormones, chemicals and nerves that exist between the brain, the heart and centers of thoughts and emotions. The heart sends the brain messages that affect our perceptions, our mental processing and our feelings.  It’s no surprise then that there is a strong StressHealth cardiovascular disease connection. You remember the last time you had a ‘heart ache’ ?!!

So how does this work?  Here are some of the specific ways that stress can lead to cardiovascular disease.

  1.  Irritability of heart muscle leading to lethal heart rhythms (ventricular fibrillation) which can cause sudden death.
  2.  Type A Behavior Pattern (hostility and anger are lethal elements)
  3. Surges of  stress hormones; Adrenaline: and Cortisol on Blood Vessels leading to High Blood Pressure and spasm of blood vessels supplying the heart (coronary arteries)
  4. Direct Effects of Adrenaline on the Heart muscle in setting of emotional stress causing sudden heart failure (Takasobu’s  Syndrome)
  5. Acceleration of Atherosclerosis (hardening of the arteries) leading to Coronary Heart Disease and Heart Attacks
  6. Increase of Fibrinogen a blood protein that causes thickening/clotting of the blood adding to likelihood of a heart attack
  7. Abnormal  metabolism including elevation of cholesterol and insulin resistance leading to (diabetes), obesity and inflammation.

What can you do to reduce your risk of cardiovascular disease due to stress?  Determine your Optimal Stress!  The economy, deadlines, relationships, a fiercely competitive 24/7 global marketplace, toddlers or toxic teenagers, technology, your health, parents aging, safety issues, taking care of everyone and everything.  Stress is inevitable!  But a balanced life is possible.

While there isn’t any silver bullet to eliminate stress from your life, you can’t afford the cost of letting stress sabotage your energy, health, joy, performance or business results.  When you read my new book, Optimal Stress: Living in your Best Stress Zone (John Wiley 2010) ( you are challenged to redefine your meaning of the word stress.  The 3P framework is the basis for understanding how your frame of reference to the events in your life can be the reason that stress keeps reappearing.  You learn how to recognize the triggers that cause you to feel out of control and disappointed.  You must learn the simple skill of true relaxation; taking a PowerPause. You can learn to identify the patterns of thinking that limit you. Most importantly you will learn how simple mind shifts and  can change your entire world.

Here are three simple streps you can begin with today:

  1. Energy. Take inventory of energy depleting thoughts and actions. Energy is an infinite capacity. Time is a finite resource.  Make a change based on your inventory. Rethink your work day. Be realistic. Schedule less. Commit to a daily routine that allows you opportunities to integrate a PowerPause or your preferred strategy for staying refreshed throughout the day.
  2. Metrics. Revisit and reestablish meaningful metrics at home and at the office. Have a conversation with your boss, subordinates, family members. Reach an agreement about what is REALLY important. Determine what are the top three measurable items that will drive more harmony at home, health and business results. Be as precise and descriptive as possible, i.e. Mom attending the 3 home games, monthly report will be redesigned to reflect current company priorities,date night at least once a month.
  3. MindShift. Redirect thoughts and feelings from situations you cant change, This is not repressing-redirecting consciously. You want peace in the now and the capacity to move forward.  Worried?  Analyze but don’t obsess. Begin to consider creating a list of things that you will ‘let go’ emotionally and physically this spring during ‘spring cleaning’

Stress Well!