When something emotionally stressful happens, you might say that your heart is breaking. But it’s just an expression – you likely know that feelings such as stress come from your brain, not from your heart.

However, it turns out there is a strong link between your emotions and heart health. Over the last two decades, numerous studies have found that your emotions and mindset can increase your risk of heart disease, especially if you’re always stressed.

Below, learn about the types of stress, how stress can affect your heart and how to reduce stress levels to improve your overall heart health.

Fight-or-flight response and the physical effects of mental stress

You probably know that stress isn’t all in your head. Even if it starts there, it doesn’t stay there. You might have symptoms like depression, anxiety and low energy. But stress also causes physical symptoms like sweaty palms, tight shoulders, acne, headaches, chronic pain, digestive problems and a racing heart.

These physical symptoms are part of what’s referred to as the fight-or-flight response. When you’re feeling stressed, your body releases large amounts of adrenaline, cortisol and other chemicals. These chemicals are helpful when you’re responding to an emergency, like if your house is on fire or your dog trotted into ongoing traffic, because they give you the energy to act quickly.

But if you’re stressed about things like work, money or an upcoming family gathering – things that aren’t related to immediate physical danger, your body doesn’t need those extra chemicals.

Healthy and unhealthy types of stress

Stress isn’t always bad – in some cases it can be good if it gives you that extra surge of energy to finish a task on time or is used as motivation. But it becomes a problem if you’re experiencing severe or frequent stress. Here’s more about the types of stress and when it can be a problem for heart health.

What is acute stress?

Acute stress happens to everyone. This type of stress is a response to sudden or scary situations – like when your friends jump out and yell “surprise” or when you narrowly miss a pothole while going downhill on a bicycle.

For most people, acute stress doesn’t have any lasting effects on their overall health. In some situations, this type of stress can even be a good thing – like when it’s down to the final point on trivia night and your teammates are looking to you for the answer. Experiencing this type of acute stress can help your body get better at handling stress in the future.

Ideally, your acute stress – and the flight-or-fight response that comes with it – should only be temporary. Once you score the winning point for your team, the physical symptoms of stress should go away, your body should return to its natural state, and there should be no long-term effects on your health. But that’s not always the case with acute stress.

When acute stress can affect physical health

Acute stress may affect your heart health if your body isn’t able to quickly recover following the stressful event. For example:

  • You experience severe acute stress. After experiencing a traumatic or life-threatening event, some people can remain stressed about the event for up to a month.
  • You experience frequent instances of acute stress. Some people may experience acute stress multiple times throughout a week or a single day due to their job, anxiety or other mental health conditions.

What is chronic stress?

If you’re experiencing stress that doesn’t go away for days, weeks or months, it’s considered chronic stress. Reasons for chronic stress include life changes, natural disasters, health concerns, money problems, mental health conditions and where you live and work. If you are experiencing chronic stress, you may:

  • Be sore, have sleeping problems or low energy.
  • Feel anxious, jittery and be unable to focus or think straight.
  • Find yourself being short with others or withdrawing completely.
  • Turn to unhealthy habits.

Chronic stress can affect every aspect of your mind, body and life. Below, we’ll show why stress can have a negative impact on your heart.

Stress and heart disease

According to the American Heart Association (AHA), “There are good data showing clear associations between psychological health and [cardiovascular disease] and risk.”

Research suggests that during stress, the amygdala – a part of the brain that deals with emotions – signals the bone marrow to produce extra white blood cells. That can cause arteries to become inflamed, bringing about a heart attack, stroke or chest pains.

The constant or frequent flood of chemicals from stress can also lead to inflammation, making it so your body’s systems don’t work as well, increasing your chance of high blood pressure, type 2 diabetes, high cholesterol and obesity – all of which are significant risk factors for heart disease.

How you choose to handle stress matters, too. Some people turn to things like food, alcohol or tobacco to relieve stress. Other people choose to watch television or other laid-back activities, missing out on physical activity to release the adrenaline in their bodies. Unfortunately, these stress behaviors further increase your chance of some heart disease risk factors, including high blood pressure, type 2 diabetes, high cholesterol and obesity. According to the AHA, there is growing evidence that these stress behaviors increase the risk factor for heart disease.

Is there a relationship between stress and heart rate?

Yes, your heart rate can increase from the adrenaline your body releases in response to stress. Sometimes it’s good to get your heart rate up like when you’re exercising to improve your heart health. But if you’re always under stress, and your heart rate is always very high, it likely means that your heart is working harder than it should.

So, what is a normal heart rate when not exercising? Most people’s hearts beat 60 to 100 beats per minute (bpm) – even lower is better. If your heart rate is consistently over 100 bpm, talk to your doctor.

How are stress and heart palpitations related?

Heart palpitations are a common symptom of your body’s flight or fight response to danger, stress or anxiety. If you’re experiencing heart palpitations, it can feel like your heart is fluttering, pounding, racing or skipping a beat. They usually come and go within a few minutes.

If you occasionally experience heart palpitations, it’s usually nothing to worry about. But if it seems like your heart is always racing, you should talk to a doctor to see if it’s stress, anxiety or something else – heart palpitations can be one of the symptoms of heart disease.

Can anxiety cause chest pain?

Chest pain from anxiety is real and it sends many people to the emergency room each year. In one study, up to 40% of people who went to the emergency room with chest pain unrelated to a heart attack had severe or moderate anxiety.

So, what’s the reason for this? It goes back to the chemicals your body releases as part of its flight or fight response. The extra adrenaline that floods your system can trigger a rapid rise in your heart rate and blood pressure numbers, making it harder for blood to move through your body. And if your heart doesn’t get enough oxygen-rich blood, it can lead to chest pain.

How can you tell if you’re experiencing anxiety or heart problems?

While chest pain can be related to stress, you shouldn’t ignore it because it can also be one of the warning signs of a heart attack. So, if your chest pain sticks around or comes and goes throughout the day, call 911.

Can stress cause a heart attack or heart failure?

The short answer is yes. The longer answer is it depends on the health of your heart and what type of stress you’re experiencing.

Acute stress

If you’re otherwise healthy, acute stress is unlikely to cause a sudden heart attack or heart failure. But if you have risk factors for heart disease, a single event could trigger a stress heart attack.

It’s also possible that severe acute stress related to a serious accident or traumatic event could cause heart failure. While heart failure due to trauma is serious, it’s usually temporary.

Chronic stress

Chronic stress increases your chance of having a stress-related heart attack or heart failure. This is because stress increases your risk factors for heart disease – based on your body’s flight or fight response and the unhealthy behaviors used to cope with stress.

Managing stress levels for a healthier heart

The good news is that, according to the AHA, making positive changes to your stress levels and mental health may also improve your cardiovascular health. Here are steps to improve your heart health and prevent heart attacks:

  • Exercise. Studies show that exercising helps improve moods. Yoga is especially good at reducing stress.
  • Watch what you eat. Good foods to reduce stress include fish, poultry, fruit, veggies and whole grains – in other words, the foods that are part of a heart healthy diet. Foods to limit or avoid include alcohol, caffeine, soda and foods high in sugar.
  • Manage work stress. Being afraid of losing a job can be stressful and can increase your chance of heart disease by about 20%. But even great jobs can be stressful – especially if you’re the type of person who’s first in line for every challenge. Pay attention to your body – if job stress is constantly raising your heart rate, giving you heart palpitations, or causing other physical symptoms of stress and anxiety, look for ways to make changes. It might be as easy as talking to your boss, collaborating with your colleagues, or not volunteering for that extra assignment.
  • Set realistic goals. You have a right to be proud of your packed schedule and ability to multitask. But if your daily accomplishments come at the expense of ongoing or chronic stress, it’s probably not worth it. Try to carve out chunks of free time during the day and give yourself more time to achieve your goals.
  • Find healthy ways to relax. Meditation, acupuncture, deep breathing and guided imagery are just some relaxing activities you could try instead of unhealthy stress behaviors. If possible, find options that might work for you before your stress levels are through the roof.
  • Talk about it. Opening up to friends or loved ones about your stress and worries can help you feel less alone. After all, everyone experiences these emotions every now and then. Also, consider talking to a therapist – they may be able to help you manage your stress and associated conditions like anxiety or depression.
  • Cry. Don’t be afraid to cry. It’s your body’s way of getting rid of cortisol, a hormone that causes stress.
  • Disconnect. A lot of our stress comes from the world around us. So, turn off the news, avoid social media and squeeze in some self-care instead.

Don’t stress about getting help for your heart

If stress or anxiety have your heart racing or skipping a beat, talk to your primary care doctor about managing stress. And if you’re at risk of heart disease, ask about a heart health screening and examination. Heart exams involve simple checkups like checking your blood pressure, checking your heart rate and a regular physical exam.