Doctors categorize stress as a risk factor for heart attacks. Acute stress combined with high blood pressure can cause a heart attack. Stress can also cause a condition called Takotsubo cardiomyopathy or broken heart syndrome.

Stress can cause high blood pressure, which can increase a person’s risk of a heart attack. Additionally, it can lead to behaviors that increase a person’s likelihood of heart disease, such as overeating and smoking.

To prevent heart attacks, people should manage their existing health conditions and aim to live a healthy, balanced lifestyle.

Read more to learn about how stress contributes to heart disease, risk factors for heart attacks, prevention, and more.

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In some cases, stress can directly cause cardiac events. These include Takotsubo cardiomyopathy, aortic dissection, which is a tear in the artery, and sudden spikes in blood pressure, also known as hypertensive emergencies.

Although these events are not heart attacks, they can look like them. For example, sudden stress can cause a condition called Takotsubo cardiomyopathy or broken heart syndrome, leading to symptoms including chest pain, shortness of breath, and nausea.

In people with this condition, stress abruptly makes the heart unable to pump enough blood throughout the body. Takotsubo cardiomyopathy is different from a heart attack, which results from blockages in the arteries. However, the condition can cause lasting damage, as it shocks the heart muscle.

More commonly, stress can indirectly increase a person’s risk of heart attacks. This happens through lifestyle factors and hormone changes.

Stress can contribute to heart attack risk by leading to behaviors that increase the risk of heart disease. These include:

Additionally, stress can cause high blood pressure, which is a risk factor for a heart attack. Cortisol, known as the stress hormone, can increase blood pressure and reduce insulin resistance.

A 2017 study looked at the amygdala, the part of the brain involved in stress, in 293 people without known cardiovascular disease. Researchers found that stress raised amygdala activity.

This, in turn, was associated with increased bone marrow activity, inflammation of the arteries, and cardiovascular events, such as heart attacks.

The authors concluded that amygdala activity strongly predicted cardiovascular events, confirming that stress is a risk factor for heart disease.

According to the American Psychological Association, ongoing stress can lead to problems in many different parts of the body.

Cardiovascular system conditions

Aside from increasing the risk of a heart attack, stress raises a person’s risk of stroke and high blood pressure. This is because it elevates their heart rate, blood pressure, and stress hormones.

Musculoskeletal system conditions

Chronic stress causes constant tension in the muscles. This can lead to conditions including:

Endocrine system conditions

The endocrine system is a group of glands that secrete hormones. Some of the organs in this system include the pancreas, ovaries, testes, thyroid gland, and adrenal glands.

Stress makes the body produce more cortisol, known as the stress hormone. This can cause physiological effects that can lead to a person developing conditions including:

Respiratory system conditions

Parts of the respiratory system include the nose, windpipe, and lungs. This system supplies oxygen to cells and removes carbon dioxide waste products from the body.

However, stress can interfere with the functioning of the respiratory system, causing shortness of breath. These effects may worsen conditions such as asthma and chronic obstructive pulmonary disease.

Gastrointestinal system conditions

The gut has millions of nerve cells that are in constant contact with the brain. This phenomenon is called the gut-brain axis.

Stress can disrupt this connection, causing bloating, pain, and gastrointestinal (GI) discomfort. It can also worsen existing GI conditions such as irritable bowel syndrome or irritable bowel disease.

Additionally, stress can affect the millions of bacteria living in the gut. This may have a negative effect on mood and thinking ability.

Reproductive system conditions

High amounts of cortisol can affect the functioning of the male reproductive system. It can both lower libido and cause impotence.

In females, stress can cause irregular menstrual cycles lower sex drive. It may also have an adverse effect on fetal development in pregnant individuals.

People cannot change certain heart disease risk factors, such as being older or male.

However, they can change or manage some risk factors, such as:

  • Smoking: People who smoke have a higher risk of heart disease than nonsmokers.
  • High blood pressure: This elevates the heart’s workload, thickening and stiffening the heart muscle. Stiffness in this area can result in abnormal heart functioning and lead to a higher risk of heart attack and stroke.
  • High cholesterol: This raises the likelihood of disease in the heart arteries.
  • Obesity and overweight: Having excess body fat, particularly around the waistline, increases a person’s likelihood of stroke and heart disease.
  • Physical inactivity: Regular moderate to vigorous exercise lowers cardiovascular disease risk.
  • Diabetes: This condition raises the risk of cardiovascular disease even if blood sugar is under control.
  • Alcohol: Drinking excess alcohol raises blood pressure and increases the risk of stroke and cardiomyopathy.
  • Poor diet: One of the best ways to fight cardiovascular disease involves eating a nutritious, balanced diet.

The Centers for Disease Control and Prevention (CDC) note that prevention involves living a healthy lifestyle and managing existing health conditions. People should take medication to manage conditions such as:

  • diabetes
  • high cholesterol
  • high blood pressure

It is also important to engage in healthy lifestyle practices, such as:

  • Eating a nutritious diet: This means focusing on foods high in fiber and nutrients, such as fruit and vegetables. It also involves limiting foods high in salt, sugar, and saturated fat.
  • Limiting alcohol intake: Males should consume no more than two units of alcohol per day, while females should consume no more than one.
  • Stopping smoking: Although stopping smoking is hard, a doctor can recommend medications and treatments that can help.
  • Exercising regularly: Experts recommend 150 minutes of moderate exercise, such as brisk walking, per week.
  • Maintaining a moderate weight: There is no one “healthy” weight for everyone, but staying at a moderate weight — rather than being significantly underweight or overweight — is associated with lower risks of many diseases.

Heart attacks are relatively common, but they are not always fatal. According to the American Heart Association, most people enjoy many more years of productive activity after a first heart attack.

However, they also note that about 20% of those aged 45 and older have a second heart attack within 5 years.

A 2021 study highlighted the danger of a second heart attack occurring soon after the first. It found that having a second heart attack within 90 days was linked to a higher mortality rate. Of those who had a second heart attack in close proximity to the first, 50% died within 5 years.

While stress is not always a direct cause of a heart attack, it does contribute to the risk.

Although people cannot change certain heart attack risk factors, such as age and sex, it is possible to change others. This includes managing medical conditions, for example, by taking prescribed medications to control blood sugar in diabetes.

Prevention also entails following a healthy lifestyle through behaviors such as avoiding smoking and getting regular exercise.