In today’s fast-paced world, stress has become an almost inevitable part of life. From workplace pressures to personal responsibilities, the constant demands placed on individuals can lead to chronic stress—a condition that quietly undermines physical health, particularly that of the heart. Often overlooked or dismissed as a psychological inconvenience, stress is now recognised by medical professionals, especially cardiothoracic surgeons, as a major contributor to cardiovascular disease. It is, quite literally, a silent killer.
Understanding stress
Stress is the body’s natural response to any demand or threat. When faced with a challenge, the brain signals the release of stress hormones such as adrenaline and cortisol. These hormones prepare the body for a “fight or flight” response—raising heart rate, increasing blood pressure, and boosting energy supplies. While this response is beneficial in short bursts, chronic activation of the stress system can lead to serious health consequences. The body remains in a heightened state of alert, which, over time, begins to wear down vital systems, especially the cardiovascular system.
Types of stress
Stress manifests in various forms, each with its own impact on the body and mind:
Acute stress: This is short-term stress that arises from immediate challenges or threats. It can be beneficial in small doses, helping individuals stay alert and focused. However, frequent episodes of acute stress can accumulate and lead to long-term damage.
Chronic stress: Chronic stress results from ongoing pressures such as financial difficulties, job insecurity, or strained relationships. This type of stress is particularly harmful because it keeps the body in a constant state of tension.
Emotional stress: Triggered by grief, trauma, or mental health disorders such as anxiety and depression, emotional stress can deeply affect both psychological and physical well-being.
Physical stress: Illness, injury, or lack of sleep can place physical stress on the body, which in turn affects the heart.
Environmental stress: Noise pollution, overcrowding, and unsafe living conditions contribute to environmental stress, which can exacerbate other forms of stress.
What stress does to the heart
Doctors frequently witness the devastating effects of stress on the heart. Unlike visible injuries, stress-induced damage often goes unnoticed until it manifests as a serious cardiac event. Some of the effects of stress on the body are:
Hypertension (high blood pressure): Stress causes blood vessels to constrict and the heart to beat faster, leading to elevated blood pressure. Over time, this damages the arteries and increases the risk of heart attacks and strokes.
Atherosclerosis: Chronic stress promotes inflammation and increases levels of bad cholesterol (LDL), contributing to the buildup of plaque in the arteries. This narrows the vessels and restricts blood flow to the heart.
Arrhythmias: Stress can trigger irregular heartbeats, known as arrhythmias. These can range from harmless palpitations to life-threatening conditions such as atrial fibrillation.
Myocardial Infarction (heart attack): Stress is a known trigger for heart attacks. The surge of adrenaline during stressful events can cause coronary artery spasms or rupture vulnerable plaques, leading to blockages and heart muscle damage.
Takotsubo Cardiomyopathy (broken heart syndrome): This condition mimics a heart attack but is caused by extreme emotional stress. The heart’s left ventricle temporarily weakens, leading to chest pain and shortness of breath.
Impaired recovery: Patients recovering from cardiac surgery or heart attacks often experience stress-related complications. Anxiety and depression can slow healing, reduce adherence to treatment, and increase the risk of recurrence.
Coping with stress
Managing stress is not just about feeling better—it’s about living longer. Cardiothoracic surgeons emphasise the importance of proactive stress management to prevent heart disease and improve overall health.
Stress management techniques include:
Lifestyle changes: The first component to this is regular exercise. Physical activity reduces stress hormones and improves cardiovascular health. Aim for at least 30 minutes of moderate exercise most days. The next component is eating a heart-healthy diet: focus on fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid excessive sugar, salt, and processed foods. Sleeping well is another crucial component: poor sleep increases stress and harms heart health. Establish a regular sleep routine and aim for 7–8 hours per night. Finally, limit alcohol and caffeine: both can exacerbate stress and increase heart rate and blood pressure.
Mindfulness and relaxation techniques: Regular meditation calms the mind and lowers blood pressure. Controlled breathing activates the parasympathetic nervous system, reducing stress. Yoga and Tai Chi combine physical movement with mindfulness, promoting relaxation and heart health.
Psychological support: Cognitive Behavioural Therapy (CBT) and other forms of counselling can help individuals manage stress and develop healthier coping mechanisms. Connecting with others who face similar challenges through support groups can provide emotional relief and practical advice. Writing down thoughts and feelings, a practice known as stress journaling, can help identify stress triggers and patterns.
Medical interventions: In some cases, doctors may prescribe medications to manage anxiety, depression, or high blood pressure. Monitoring heart health through routine exams and regular health check-ups can catch problems early and guide treatment.
Work-life balance: Set boundaries, by learning to say no and prioritising tasks to avoid burnout. Short breaks during the day can refresh the mind and reduce stress. Engaging in hobbies also helps: activities that bring joy and relaxation can counteract stress.
Stress is manageable
As cardiothoracic surgeons, we often meet patients at the end of a long journey of silent suffering. By the time they reach the operating table, the damage caused by stress is already done — arteries are blocked, heart muscles are weakened, and lives are hanging in the balance.
But it doesn’t have to be this way.
Stress is manageable. With awareness, lifestyle changes, and support, individuals can protect their hearts and lead healthier, more fulfilling lives. The key is to recognise stress: not as a badge of honour or a necessary evil, but as a warning sign—a signal that something needs to change.
In the battle against heart disease, managing stress is one of the most powerful tools we have. It’s time to listen to our hearts before they cry out in crisis.
This article was first published in The Hindu’s e-book Care and Cure.
(Vinayak Shukla is senior consultant, cardiothoracic surgery, Naruvi Hospitals , Vellore. vinayak.s@naruvihospitals.com; Ray George is consultant, cardio- thoracic and vascular surgery, Naruvi Hospitals, Vellore. ray.g@naruvihospitals.com)
