UPDATE: You eat healthy and exercise, but you have clogged arteries or worse yet, had a heart attack. You wonder how that could possibly be. Well, here’s one of the key (and most overlooked) reasons why… STRESS. 

Are You Stressed Out?

Psychological stress can emerge when you’re unable to cope or respond to real-life demands (stressors), e.g.,  unemployment, caregiving for the the chronically ill, family dysfunction, poverty, and/or work, marital, or financial issues. According to the American Psychological Association (APA, 2011), there are two types of stress:

  1. Acute stress – short-term form of stress that stems from the demands and pressures of the recent past and anticipated demands and pressures of the near future.
  2. Chronic stress – long-term form of stress that derives from unending feelings of despair/hopelessness.

Coping with Stress

Coping skills are essential in stress management. How well do you manage your stress? Take this 20-minute Coping and Management Skills Test in Psychology Today and find out. Also, take the self test on identifying your stress triggers, the first step to dealing with chronic stress.

Various studies have shown that exposure to persistent stress can result in long-term or permanent changes in the way you respond:

  • Emotionally – e.g., increased likelihood of depression
  • Physiologically – e.g., decreased ability to regulate inflammatory responses due to decreased tissue sensitivity to cortisol (your primary stress hormone and regulator of inflammation)
  • Behaviorally – e.g., increased smoking, decreased exercise and sleep, poor medical compliance

These changes can affect your susceptibility to and the development and progression of disease.

The Culprit: Cortisol

When you’re under stress, your brain triggers the release of hormones in your body, primarily cortisol and adrenaline, which elicits the stress response or the “fight of flight” response. This reaction helped our prehistoric cousins to confront animal attacks and other predators as well as avoid environmental danger. Today, challenging situations of daily living can set off the stress response and result in:

  • Increased blood pressure
  • Increased heart rate
  • Greater energy levels

If the perceived threat never passes (that is, stressors are always present), your body constantly feels under attack.

Consequences of Excess Stress

A study on patients with Cushing’s syndrome, also known as “hypercortisolism”, revealed cortisol contributes to cardiovascular risk. Cushing’s syndrome is a hormonal disorder caused by prolonged exposure to cortisol. This study is significant because it provides evidence that links cortisol with heart disease, a major cause of morbidity and mortality in Cushing’s syndrome patients.
Prolonged exposure to cortisol is linked with the following cardiovascular risk factors:

  1. High blood pressure – Cortisol may contribute to about 30% of all cases of hypertension. Long-standing high blood pressure can lead to weakened blood vessels and damaged heart muscle (cardiomyopathy). When you sustain injury to the muscles of your heart, your heart becomes weaker and is less efficient at ‘pumping’ and circulating blood efficiently. The result… heart failure.
  2. Chronic low-level inflammation (which leads to chronic disease). Inflammation is partly regulated by cortisol and when cortisol is not allowed to do its job, inflammation can get out of control. See Inflammation / Foods that Heal and Harm to find out how to measure inflammation.
  3. Central obesity (belly fat)
  4. Weight gain
  5. Increased risk for type 2 diabetes (hyperinsulinemia, hyperglycemia, insulin resistance)
  6. Dyslipidemia – low HDL (“good” cholesterol), high LDL (“bad” cholesterol), higher total cholesterol, and/or high triglycerides
  7. Atherosclerosis of the carotid arteries (due to salivary cortisol exposure)

Overexposure to Stress Hormones

A Carnegie Mellon University study found that overexposure to cortisol and other stress hormones from chronic psychological stress are also associated with developing:

  1. Depression
  2. Infectious diseases
  3. Common colds – Cold symptoms are not caused by the virus but are a “side effect” of your inflammatory response. If your immune system is unable to regulate the inflammation caused by fighting off an infection (i.e., immune cells become insensitive to cortisol’s regulatory effect), you’ll be more prone to developing a cold. Worse yet, when inflammation is out of control, you’re more vulnerable to developing other diseases.

How to Manage Your Stress

When stress is high, relaxation is more than a luxury, it is a NECESSITY.  Learn to control your stress cycle. 

Practice DEEP BREATHING and take time to clear your mind. Fight back when your body is under assault. Even in your most wound-up moments, you can relax in just 10 minutes a day.

  • INHALE for 5 seconds (through your nose) , then EXHALE for 10 seconds (through your nose or mouth).
  • Slow, rhythmic breathing can stimulate the “relaxation response” — a state of profound rest (opposite of the stress response).
  • Laughing lowers stress hormone levels!

Karen’s Fit Tip: Your immune system’s ability to regulate inflammation is the greatest predictor of your health and explains how stress can promote disease. If you’re not a believer in the wonders of meditation, give it a try. Take your blood pressure before and after 10 minutes of relaxation and compare the results.

Cardiovascular Consequences of Cortisol Excess. Vascular Health Risk Management. Dec 2005.
How stress influences disease: Study reveals inflammation as the culprit. Science Daily (Carnegie Mellon University). Apr 2012.
Psychological Stress and Disease. Journal of the American Medical Association (JAMA). Oct 2007.
Salivary cortisol is related to atherosclerosis of carotid arteriesJournal of Clinical Endocrinology Metabolism. Oct 2008.

Karen Owoc

Karen Owoc is a certified Clinical Exercise Physiologist specializing in cardiopulmonary rehabilitation and lifestyle medicine. Her science-based approach to longevity, nutrition, and muscle health has made her the go-to source for health seekers and medical professionals alike. Karen's best-selling book on functional longevity, "Athletes in Aprons: The Nutrition Playbook to Break 100", and her transformative perspective have mended many minds, hearts, and spirits.

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  1. See “Heal Your Heart” by Michael Miller MD

    1. I will. Thank you, Larry!

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