Excerpted from a  NY Times article. 

  • Do you get irritated easily, such as yell at the slow driver in front of you? 
  • Are you hostile toward others?
  • Are you highly self-critical?
  • Do you have chronic stress, such as financial insecurity, living in a high crime area or have longstanding anxiety or depression? 
  • Do you have life stressors such as the death of a loved one or loss of a job or home? 
  • Do have high-conflict relationships? 

These are all forms of psychological stress, which activates the fear center in the brain, or amygdala. Stress causes the “fight-or-flight” response, triggering release of hormones that can lead to heart attacks and strokes. These hormones also increase body fat, blood pressure, and insulin resistance (diabetes). Also an effect is inflammation in the arteries, which damages the blood vessels, and can lead to heart attacks and strokes. 

Traditional risk factors for heart disease are high blood pressure, high cholesterol, smoking, diabetes, obesity and physical inactivity. Doctors are realizing that they have been neglecting a critically important hazard to heart health: stress. 

Chronic psychological stress, recent studies indicate, may be as important — and possibly more important — to the health of your heart than the traditional cardiac risk factors. In fact, in people with less-than-healthy hearts, mental stress trumps physical stress as a potential precipitant of fatal and nonfatal heart attacks and other cardiovascular events, according to the latest report.

  • A study in JAMA (Nov. 2021) studied people with heart disease and the impact of physical and psychological stress. Those who had more reaction to mental stress in the study were more likely to suffer a nonfatal heart attack or die of cardiovascular disease in the 4-9 years after the study. 
  • Another study known as Interheart followed nearly 25,000 people in 52 countries and found that patients who experienced a high level of psychological stress during the year before they entered the study were more than twice as likely to suffer a heart attack during an average follow-up of five years, even when traditional risk factors were taken into account. 
  • Another study did scans that checked brain activity under stress. Healthy individuals with high activity in the amygdala had higher inflammation and atherosclerosis five years later. 


  • Mindfulness-based meditation and deep breathing
  • Yoga
  • Tai-chi
  • Aerobic exercise (walk, run , bike, swim, dance)
  • Consistent sleep habits, avoid technology and wake and rise at the same times. 
  • Emotional regulation skills to manage your reactions to life’s irritations. 
  • Limit caffeine intake
  • Learn mindful self-compassion skills to reduce self-criticism and improve self-soothing.

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