New Study Explains Link Between Stress and Heart Disease

Did you know that your mental well-being affects more than just your mood? New research shows that living with depression or anxiety may put your heart at risk, too. 

“Your mental well-being is not a luxury—it’s part of your health,” says Shady Abohashem, MD, MPH, a Mass General Brigham researcher and lead author on the study published in Circulation: Cardiovascular Imaging. “If you take care of your emotional well-being, that will also reflect on your heart health.”

The brain-heart connection: What the research found

Dr. Abohashem and colleagues followed 85,551 people enrolled in the Mass General Brigham Biobank for up to 10 years. In the recent study, they found depression or anxiety increased risk of major cardiovascular events.

During the study time, 3,078 participants experienced major cardiovascular events such as heart attack, heart failure, or stroke. Those with multiple mental health conditions fared the worst.

“People who have both depression and anxiety had a greater risk for heart attacks and stroke—almost a 32% relative increase in risk compared to people who only have one condition,” says Dr. Abohashem. This finding held even after the researchers accounted for traditional risk factors like smoking and hypertension, and health behaviors like sleep and exercise.

How stress affects the brain and heart

The study suggests that three key factors may drive the link between brain and heart health: stress-related brain activity, nervous system dysregulation, and chronic inflammation. 

The research team took brain scans and health indicators for a small group of participants. They looked at the amygdala, a brain region associated with stress. They also measured heart rate variability (HRV), the time between heartbeats. HRV indicates autonomic nervous system dysregulation. This occurs when the nervous system controlling automatic body functions doesn’t work properly. Symptoms include fatigue, dizziness, heart rate changes, and trouble handling stress. Finally, they looked at CRP, a protein that’s a marker for inflammation.

They found that people with anxiety and depression had higher stress-related brain activity and CRP. They also had lower HRV (a sign of nervous system dysregulation).

“All of these pathways are linked, and they partly explain the cardiovascular disease risk we saw for people with anxiety or depression in our study,” Dr. Abohashem says. Higher stress activity in the brain keeps the body on alert, which increases heart rate, blood pressure, and chronic inflammation. Over time, these changes can damage blood vessels and fuel heart disease.

Mind-body approaches to prevent heart disease

“The good news is that this increased cardiovascular risk is preventable,” Dr. Abohashem says. The study findings suggest that reducing stress may help prevent heart issues, especially for people with depression or anxiety. 

Here are the lifestyle strategies Dr. Abohashem recommends to protect your brain and heart:

Manage stress.

One of the most effective ways to reduce stress and its effects on your health is to manage it. “There’s an evidence-based benefit from stress management techniques in reducing heart disease,” Dr. Abohashem says. 

Researchers have found that mindfulness meditation, for example, reduces blood pressure and heart rate. To practice, sit or lie in a comfortable position and close your eyes. Focus attention on your breath and observe thoughts or feelings without judgment. Even 2- or 3-minute sessions can reduce stress. 

Boost sleep quality.

“People underestimate the importance and significance of maintaining a good sleep routine,” Dr. Abohashem says. Poor sleep is a contributing factor for developing depression and anxiety, he notes. It’s also linked to a higher risk of heart attack and stroke. 

Improve sleep quality by:

• Avoiding screens and stressful activities at least 30 to 60 minutes before bed
• Exposing yourself to natural morning light after waking
• Keeping your bedroom cool and dark
• Waking up and going to bed at the same time every day

Exercise often.

Regularly moving your body offers unique benefits for both mental and heart health. “Exercise has been shown to reduce the stress response in the brain,” Dr. Abohashem says. In one of his studies, people who met physical activity recommendations had lower stress-related brain activity and a 23% lower risk of heart disease than those who didn’t. Notably, exercise was roughly twice as effective at lowering heart disease in people with depression.

Aim for at least 150 minutes of moderate-intensity aerobic activity and two full-body strength sessions per week. Dedicating even 20 minutes to exercise per day will have benefits, Dr. Abohashem says. 

When to seek mental health treatment

While lifestyle changes offer significant benefits, treatment may be necessary for symptoms that don’t improve with lifestyle changes.

“If you’ve been living with depression or anxiety for a long time, that could cause cardiovascular disease, even if you look healthy from the outside and are free from traditional risk factors like smoking, diabetes, or hypertension,” warns Dr. Abohashem.

Don’t wait. Early intervention protects both your mental health and heart. Talk to your primary care provider (PCP) if anxiety or depression interferes with daily life. They can connect you to a mental health provider for diagnosis and treatment. Often, a combination of medication and psychotherapy is most effective.

“Taking care of your brain is also part of taking care of your heart,” says Dr. Abohashem.