As a Board-Certified Specialist in Cardiovascular & Pulmonary Physical Therapy, I typically see patients after they have had surgery to repair obstructed vessels, faulty valves, or, in advanced cases, after placement of heart assistive devices or transplant. These are folks who are at the end stages of their heart disease. My role is to assist them to function optimally after surgery — teaching them the basics of how to safely maneuver in/out of bed after a painful chest incision, learn how to walk again, prescribe an exercise program, and impart strategies on preventing further heart disease through maintaining a healthy lifestyle. What is the one strategy that will now be topping my list? Learning to manage stress levels.

A new study published last week in The Lancet now suggests a direct link between stress and heart disease risk — and it doesn’t start in the heart, but rather the brain. Shelby Lorman brought this to our attention in her post a few days ago. The study found that high stress levels activated an area in our brain known as the amygdala — the area that processes emotions. Researchers found that activity in the amygdala led to increased metabolic activity in the bone marrow (the area of our body responsible for producing white blood cells), producing inflammation in the arteries. The participants in the study that had high amygdalar activities showed greater risk of cardiovascular events.

For years, scientists have presumed an indirect link between stress and heart disease. From a physiologic standpoint, chronic stress produces unhealthy levels of adrenaline and cortisol (stress hormones) in the blood, leading to elevated heart rate and blood pressure, and the potential for a heart attack or stroke. Many of the known behaviors associated with risk factors of heart disease, such as poor diet, obesity (due to excess eating, lack of sleep and/or exercise), alcoholism, and smoking may all be exacerbated when we’re stressed.

According to the CDC, cardiovascular disease is the leading global cause of death, accounting for 17.3 million deaths per year, expected to grow to an astounding 23.6 million by 2030. Although some risk factors of heart disease are not modifiable — such as congenital defects, family history, ethnicity, or age — STRESS is something that we can learn to control. Here are a few science-backed strategies that can keep your stress down and your heart healthy.

  1. Physical Activity — To improve overall cardiovascular health, the American Heart Association (AHA) suggests at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise. Roughly, thirty minutes a day, five times a week can keep your stress at bay and your heart strong. Exercise also leads to overall emotional and physical well-being.
  2. Laugh Often — This is no joke (pun intended). There is a burgeoning of laughter clubs popping up all over the place. Laughter has great short-term benefits, including stimulating circulation, releasing endorphins, and decreasing blood pressure. Long-term benefits show an improved immune system, relief from pain, and enhanced overall mood. A recent study showed that laughter also contributed to improved memory.
  3. Meditate — Sara Lazar, a Harvard neuroscientist conducted a study showing that the brain physically changed in those who participated in a 8-week mindfulness-based stress reduction program. Specifically,the amygdala, which we now know has a big correlation with stress level and heart disease, actually got smaller in the group that went through the program.
  4. Express Yourself — Whether it’s through journaling or spending time with loved ones, getting your frustrations out will help you manage your stress. A recent study from USC suggests that sharing your stressors with someone who understands your emotions and has been in a similar situation will help ease your stress level.
  5. Get Enough Sleep — For those who don’t sleep well, 21 percent reported feeling more stressed. Adults with higher reported stress levels were even worse off — 45 percent felt even more stressed if they didn’t get enough sleep. Whether lack of sleep leads to stress or stress leads to lack of sleep, we know that chronic sleep deprivation can contribute to a host of health problems, including obesity and high blood pressure which are two culprits of heart disease. The National Sleep Foundation suggests 7–9 hours of sleep for most adults. You may find that working-out, laughing often, meditating, and spending time with loved ones, may, in fact, help you sleep better.

The benefits of reducing stress in our lives can extend far beyond psychological and physical well-being. Our stress levels may soon become an important screening tool for determining whether our hearts and our minds stay healthy.

Originally published at