Chronic Stress and Your Heart Attack Risk


Stress of Live

The ‘Chronic Stress’ factor refers to the presence of persistent stress challenges in one of three areas: work, home, and finances. These three are central to your life, and persistent stresses in any one of these will impact your stress levels hard.

If you had a peak in the Chronic Stress portion of your profile this article tells you what you

  • need to know about what it is,
  • how it impacts you, and
  • what you can do about it.

 Moderate Chronic Stress is a Challenge

If you have Moderate Chronic Stress you will have challenges in one of the three areas outlined above.  Look at your profile report to determine which of the three areas (work, home and finances) you will need to make changes.

It is helpful to pause at this point and count your blessings. The fact that two of the three areas are going well is very important. It affirms that you are doing a lot of things right. Spend some time reminding yourself of all the things you are doing right in those areas.  Write some of those down if you can.

With that perspective, now turn to the area that is challenging you. Set your personal plan of how you are going to reduce these in the next few months.

Start with becoming more aware of what activities, people and interactions aggravate your distress in these settings. That will help you decide what you can do to reduce these stresses.

Think of having a Moderate Chronic Stress level as a prompt to action.

If you can respond to the signal with a plan, execute your plan, and start establishing what works and what does not, you are using these challenges to your advantage. If you ignore the challenge and these stresses persist,  your reactions can be pushed into High Chronic Stress.

High Chronic Stress is Overload

A High peak in Chronic Stress  means that you have challenges in two, or all three of these critical areas. The situation of having stress at home and at work means that there is nowhere to hide. The physiological tension in your body will be unremitting, and mentally you start to feel hopeless about effecting any changes in any domain.

You are many times more vulnerable to develop chronic problems, including increased emotional and physical problems. This can lead to psychiatric problems that are harder to change. These patterns are persistent, layered, and tend to reinforce each other.

If you want to get out of this danger zone you will definitely have do things differently. Look through the Steps you can Take section and find your starting point. Then start immediately and don’t quit until you get permanent results.


Chronic Stress compounds distress in your body. That distress will be evident in nervous system hyperarousal, more circulating stress hormones, increased activity in your inflammatory reactions, and stickier blood flow.

While doctors have always understood that chronic stress is particularly hard on your health, it was not until the INTERHEART study that we understood that the presence of Chronic Stress increases your likelihood of having a heart attack, whether or not you think you are doing a good job with managing that stress or not. The presence of these factors was cumulative, and each area was equally important.


There are so many things you can do to reduce Chronic Stress. Below you’ll find a number of ways you can start.

Steps to Take for Moderate Chronic Stress

A. Reflect on your Strengths

♥ Write a list of your attitudes, skills, and behaviors that work for you in these areas

♥ Consider which of these attitudes, skills and behaviors you can most effectively use in the persistent stress area

B. Chose a Focus for Change

♥ Be aware of your sense of helplessness, and ask whether you are ready to act

♥ Chose a single context, person, or problem that you feel you can be successful with

♥ Take 15 minutes and write as many ways you can think of changing the problems you are facing

♥ Do not criticize or dismiss any of your answers

♥ Take your completed list and rate each idea from 0 to 10, based on how likely it is you feel you can do this in the next week

♥ Select the idea with the best rating and use only that idea for the next week

C. Choose one Stress Reduction Skill to manage your Stress Reactions as you Tackle Change

♥ Diaphragmatic Breathing techniques

♥ Progressive Muscle Relaxation skills

♥ Visualization

♥ Affirmations

♥ Meditation

♥ Cognitive Reframing

Steps to Take for High Chronic Stress

A. Use the Steps outlined (Moderate section) on your easiest Chronic Stress

B. Use the Steps again for the harder Chronic Stress

C. Use the Steps again for the hardest Chronic Stress

D. If you are getting frustrated (or are not improving), get help from a Coach, Counselor or Psychotherapist

♥ Working with a psychologist, social worker, or psychotherapist, to guide you through making necessary changes to your life and stress problems

♥ The options include Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IT), brief Psychodynamic Therapy, and Behavioral Therapies


You will find additional options and information on our membership pages. Below are more resources that I would highly recommend:

Time Management from the Inside Out. 2nd Edition (2004) Julie Morgenstern, Henry Holt Co: New York.

The Disease to Please: Curing the People Pleasing Syndrome. (2001) Harriet B. Braiker, McGraw-Hill: New York.

The Relaxation and Stress Reduction Workbook 6th Edition (2008) Martha Davis, Elizabeth Robbins Eshelman and Matthew McKay, New Harbinger Publications: Oakland CA.

Stress Less: The New Science That Shows Women How to Rejuvenate the Body and the Mind. Thea Singer Hudson Books: New York.


Doctors and health providers may be interested in current up to date scientific information on the relationship between chronic stress and heart disease. I highly recommend starting with:

Stress Proof the Heart: Behavioral Interventions for Cardiac Patients. Ellen A. Dornelas (Ed.) Springer: New York.

Stress and Cardiovascular Disease (2012) Paul Hjemdahl, Annika Rosengren and Andrew Steptoe (Eds.) Springer Books: London UK.

Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention: Translating Knowledge into Action, 3rd Edition (2009). Canadian Association for Cardiac Rehabilitation: Chapter 6, pages 107-202.