People who think that stress is affecting their health “a lot” are at a much higher risk of heart attack compared to those who do not think stress plays such a big role in their overall health.

The findings come from the UK’s Whitehall II study, which has tracked several thousand civil servants in London for over two and a half decades. The study was published in the European Heart Journal.

The team found that the risk of heart attack doubled among those who believed stress affected their health “to an extreme extent”.

It has already been established that stress can negatively impact human health. Researchers at The University of Western Ontario provided the first direct evidence using a biological marker, confirming that chronic stress can play a role in triggering heart attacks.

However, this is the first study ever to focus solely on how a person’s perception of the negative effects of stress on their health actually leads to health complications.

Dr Hermann Nabi, the first author of the study and senior research associate at the Centre for Research in Epidemiology and Population Health at Inserm (Institut national de la santé et de la recherche médicale), Villejuif, France, said that “this current analysis allows us to take account of individual differences in response to stress.”

A total of 7,268 people who were followed for 18 years were given questionnaires about the impact of stress on their health. There were 352 heart attacks during the 18 year follow-up period.

The researchers asked the participants whether they thought their health was affected by stress level. The participants were split into three different groups, depending on their answer:

  • No effect group – the respondents believed stress had no impact on their health
  • Slight effect group – the people believed stress had a slightly negative impact on their health
  • “A lot” or “extremely” group – here, the respondents said stress affected their health “extremely” or “a lot”

The participants were also asked questions concerning their eating habits, alcohol consumption, physical activity, and smoking status/habits. In addition, the research team gathered information about their blood pressure, BMI, ethnicity, socio-economic status, and age.

Using health records collected from the British National Health Service, the team found out how many participants had suffered from a heart attack by 2009.

The study revealed that the people who said they believed stress “extremely” affected their health at the beginning of the study period were much more likely to suffer from a heart attack than those who said stress “did not affect their health at all”.

The researchers had made adjustments for biological, behavioral and other psychological risk factors.

According to Dr Nabi, the association observed between an individual’s perception “of the impact of stress on their health and their risk of a heart attack was independent of biological factors, unhealthy behaviours and other psychological factors.”

He added:”One of the important messages from our findings is that people’s perceptions about the impact of stress on their health are likely to be correct.”

People’s perception of stress on their health should be included in future research, say the authors. When dealing with stress-related health issues, doctors should also bear in mind the patients’ subjective perceptions.

Dr Nabi said the findings “show that responses to stress or abilities to cope with stress differ greatly between individuals, depending on the resources available to them, such as social support, social activities and previous experiences of stress. Concerning the management of stress, I think that the first step is to identify the stressors or sources of stress, for example job pressures, relationship problems or financial difficulties, and then look for solutions.

There are several ways to cope with stress, including relaxation techniques, physical activity, and even medications, particularly for severe cases. Finally, I think that the healthcare system has a role to play. The conclusion of a recent study conducted for the American Psychological Association tells us that health care systems are falling short on stress management, even though a significant proportion of people believe that the stress or pressure they experienced has an impact on their health.”

The authors concluded that “although, stress, anxiety, and worry are thought to have increased in recent years, we found only participants (8%) who reported stress to have affected their health ‘a lot or extremely’ had an increased risk of CHD. In the future, randomized controlled trials are needed to determine whether disease risk can be reduced by increasing clinical attention to those who complain that stress greatly affects their health.”

Heart disease deaths have decreased by more than half in Europe since the 1980s, according to another recent study also published in the European Heart Journal.

A team of experts from Pennsylvania State University reported in Annals of Behavioral Medicine that contrary to popular belief, stress is not the cause of health problems, it is how we react to stressors that matters.

Research leader, Professor David Almeida explained that how people react to a stressful situation today can predict their health problems a decade later, regardless of their present health and stressors.

Professor Almeida said “For example, if you have a lot of work to do today and you are really grumpy because of it, then you are more likely to suffer negative health consequences 10 years from now than someone who also has a lot of work to do today, but doesn’t let it bother her.”

Written by Joseph Nordqvist