Psychological stress has been linked to both the development and progression of coronary artery disease (CAD). In people who already have CAD (a buildup of cholesterol-laden plaque that narrows the arteries to the heart), the body’s response to stress may impact risk for future heart attack or heart failure.
Researchers gave 629 people with stable CAD two minutes to prepare a speech and three minutes to deliver it in front of a panel of people wearing lab coats. Before and during this stressful experience, the researchers measured blood pressure, heart rate, and how much blood was making it to the fingertips (peripheral vasoconstriction). Before and 30 minutes after the stress test, an ultrasound was used to measure how much an artery widened when blood flow increased (flow-mediated vasodilation). The participants were followed for an average of six years to see if they had any heart attacks or any hospitalizations for heart failure.
A blunted blood pressure and heart rate response to stress, less vasodilation (widening of the artery in the arm), and/or more vasoconstriction (less blood flow to the fingertip) were associated with higher risk of future adverse cardiac events.
Being able to identify these risk factors opens the door to developing interventions to address them and reduce risk. In the meantime, although it’s not possible to avoid all stress in life, it may be helpful to practice stress-reduction techniques like mindfulness (see February 2025 issue) and perhaps say “no” to situations that cause acute stress when possible, especially if you already have CAD.