By American Heart Association News

Sometimes stress can be useful. But constant stress can affect overall well-being and may even impact heart health.

When stress is short-lived, it can help with performance in meeting a major deadline, interviewing for a new job or achieving another goal. Stress and its impact on the body can also be lifesaving in the face of danger.

But long-term stress induced by work troubles, financial difficulties or family discord is a different story, said Dr. Ernesto L. Schiffrin, physician-in-chief at Sir Mortimer B. Davis-Jewish General Hospital in Montreal.

"Irritability, anxiety, depression, rumination and insomnia or waking up in the middle of the night with anguish" can result from chronic stress, he said.

Ongoing stress not only takes an emotional and psychological toll, it can produce physical symptoms. Those may include headaches, an upset stomach, tense and aching muscles, insomnia and low energy.

Heart disease is another potential stress-related problem.

Stress may lead to high blood pressure, which can pose a risk for heart attack and stroke. Stress also may contribute to such cardiovascular disease risks as smoking, overeating and lack of physical activity.

"Chronic stress has been shown to be associated with increased cardiovascular events," Schiffrin said. He pointed to a 2017 study in The Lancet that used images of part of the brain involved with fear and stress and found links between stress and cardiovascular disease episodes. Brain activity was studied along with bone marrow activity and artery inflammation.

"These findings illustrate mechanisms through which emotional stressors can lead to cardiovascular disease in human beings," Schiffrin said.

Constant stress can impact creativity and productivity. For many people, the workplace is a source of stress.

About 2 in 3 employees say work is a significant source of stress, according to a recent report from the American Heart Association Center for Workplace Health Research & Evaluation. Job stress can stem from long hours, physical strain, high demand or job insecurity.

Annual expenditures on work-related stress has been estimated at $190 billion, while the cost of poor mental health, including depression and anxiety, has been pegged at $211 billion annually. The estimates encompass lost productivity and work absenteeism.

To minimize continual stress, set priorities for what is most important to you and aim for a life-work balance, Schiffrin said.

Make time for friends, family and laughter. Ease stress and improve mood through physical activity. Regular exercise helps to lower blood pressure and combat other cardiovascular disease risk factors. Mindful meditation and deep breathing can help manage stress. Consider yoga, which combines movement, controlled breathing and relaxation.

Sleep and stress are interconnected. Stress can affect sleep, and lack of sleep can, in turn, lead to more stress. Seven to eight hours of sleep per night is ideal, Schiffrin said.

"Better sleep hygiene is critical in management of stress and promotion of heart health," he said.

Sleep in a cool, dark and quiet room; don't exercise close to bedtime; and avoid eating or drinking in the hours before bedtime, especially alcohol and foods high in fat or sugar, he said.

For unending stress or symptoms of depression, talk with a health care provider about getting help.

Attempting to see a "silver lining" and adopting a positive attitude toward life may help reduce stress, Schiffrin said.

"Adopting some degree of serenity in the face of life's challenges," he said, "may help improve the perception of stress and result in better quality of life and better cardiovascular health."

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