Manage Your Stress to Help Your Heart

Low stress resilience may undermine effects of exercise on heart health later in life

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Exercise in your teens is a good thing, but even with exercise, poor ability to cope with stress may affect your heart later in life.

A new study from Sweden and the UK found that men who had trouble dealing with stress in adolescence were more likely to develop heart disease later in life. Exercise is known to help protect against heart disease. However, the authors of this study found that men with poor stress resilience had an increased risk of heart disease compared to their more mellow peers.

The authors of this study said doctors should promote both exercise and stress reduction to reduce heart disease risk.

Amir Darki, MD, an assistant professor of cardiology with Loyola Medicine in Chicago, told dailyRx News that doctors should educate their patients about stress and heart health.

"I think it is important for physicians to educate patients that while we don’t completely understand the 'cause and effect relationship' that stress has on cardiovascular health, there is overwhelming evidence that negative lifestyle behaviors associated with stress (overeating, poor sleep hygiene, tobacco and alcohol use, and lack of exercise) have been associated with adverse cardiac events including heart attacks," Dr. Darki said. "Additionally it is important for our patients to understand that effectively managing stress means not only developing physical health but also emotional and mental health which has been linked to heart disease."

Dr. Darki continued, "Additionally, we need to become mindful in eating a healthy, well portioned diet that includes low fat and cholesterol with plenty of fruits and vegetables."

Dr. Scott Montgomery, a professor in the Department of Epidemiology and Public Health at University College London, led this study.

In an interview with the journal Heart, Dr. Montgomery noted that poor physical fitness and chronic stress are both known to increase the risk of developing heart disease later in life. Past research, according to Dr. Montgomery and team, has found that men with high levels of physical fitness as adolescents had a reduced risk of heart disease later in life.

However, Dr. Montgomery noted in the interview, "amongst men who had low stress resilience, the benefit of even high levels of physical fitness in protecting against coronary heart disease was lost. This suggests that other exposures associated with low stress resilience may overwhelm the benefits of having good physical fitness or that those with low stress resilience perhaps are more likely to give up exercising as they age.”

Between 1952 and 1956, military service was mandatory for all Swedish men. Dr. Montgomery and colleagues studied over 237,000 men who were conscripted from 1952 to 1956.

During the conscription exam, doctors conducted extensive medical, psychiatric and physical exams on men aged 18 and 19.

In addition to information about physical fitness, psychologists gathered data about stress resilience on each recruit. Stress resilience is the ability to cope with stress.

Dr. Montgomery and team matched that information to data on heart disease from the Swedish National Patient register between 1987 and 2010. They found that men with low stress resilience as teens were more likely to develop heart disease and to die of a heart attack.

Men with poor stress resilience tended to be less physically fit than their peers at the time of the conscription exam, Dr. Montgomery and team found. However, they also found that even men who were physically fit as teens still had a higher risk of heart disease later in life if they had poor stress resilience.

These researchers noted that although their data did not include information on smoking, other studies of conscripts during 1969 found that men with low stress resilience also tended to be smokers. Smoking can increase the risk of heart disease.

This study was published March 4 in Heart.

The UK Economic and Social Research Council, Stiftelsen Olle Engqvist Byggmästare, Folksam and Örebro University funded this research. Dr. Montgomery and team disclosed no conflicts of interest.


Review Date: 
March 5, 2015
Last Updated:
March 26, 2015