The Connection Between Stress and Heart Health: A Conversation with Dr. Garrett Ruth
Written by Melissa Schenkman, MPH, MSJ
Garrett Ruth, MD, FACC, FSCAI
February is Heart Month, and one of the most talked-about topics is the impact of stress on heart health. Many millennials experience chronic stress, but not all of us understand how it affects the heart or the physiological processes that contribute to heart disease. To shed light on this important issue, I spoke with Dr. Garrett Ruth, a cardiologist from South Carolina.
Understanding the link between stress and heart health
Q: Can you explain the connection between stress and heart health? What’s the science behind it?
“Stress is a part of everyday life, and its impact on heart health depends on both its frequency and intensity. I like to break it down into two types: chronic stress and acute stress.
Chronic stress is the everyday stress we experience from factors like sleep deprivation, work pressure, and emotional strain. This kind of stress triggers the release of stress hormones such as catecholamines and cortisol from the adrenal glands. These hormones activate the body's fight-or-flight response, leading to increased blood pressure, heart rate, and blood sugar levels. Over time, this sustained hormonal response contributes to inflammation, elevated cholesterol, and plaque buildup in the arteries, all of which increase the risk of heart disease.
On the other hand, acute stressors—major traumatic events—can have immediate and severe effects. They can cause plaque rupture in the arteries, leading to heart attacks. Sudden spikes in blood pressure due to stress can also result in arterial tears or electrical disturbances in the heart, such as arrhythmias like atrial fibrillation, which we see frequently in hospitals.”
The reality of stress-related heart issues for millennials
Q: Many millennials are constantly under stress—whether from work, parenting, or even caring for aging parents. How do these stressors impact heart health at a relatively young age?
“Stress doesn’t just start affecting your heart later in life; it builds up over time. The longer you experience chronic stress without management, the higher your risk of developing heart issues earlier than expected.”
Managing Stress for a Healthier Heart
Q: Given how much stress can impact heart health, what are some effective ways to manage it?
“Managing stress is a multidisciplinary approach, and it looks different for everyone. Some of my patients find yoga and meditation incredibly helpful, while others benefit from regular exercise. Therapy and mental health support are also crucial, especially now that mental health awareness has grown significantly over the past decade.
The key is to find what works for you. I always emphasize the importance of sleep—getting at least seven hours per night can help lower inflammation and reduce stress levels. Exercise is another powerful tool, whether it’s high-intensity workouts or moderate activities like walking. Studies show that staying active plays a major role in long-term heart health. In fact, many of my healthiest elderly patients—some over 100 years old—attribute their longevity to staying active.”
Scientific insights: A new study on stress and heart disease
Q: Speaking of research, a new study from the Journal of the American Heart Association explores how mental stress impacts patients with coronary artery disease. Can you share your thoughts on this study?
“The study examined how patients with coronary artery disease reacted to stress. Researchers measured their vascular response using a blood pressure cuff and ultrasound to determine how well their arteries widened after stress exposure. They found that individuals whose arteries responded poorly to stress had a higher risk of major cardiovascular events—like strokes and heart attacks—over the next several years.
While it’s a relatively small study, the findings reinforce what we already suspect: people who handle stress poorly have worse long-term heart outcomes. This research helps provide objective data on a very subjective issue.”
Final thoughts
Q: This has been incredibly insightful. To wrap up, what are the most important steps people should take to reduce stress and protect their hearts?
“Prioritize sleep, stay active, and find a stress-relief method that works for you. Whether it’s exercise, therapy, or mindfulness practices, managing stress is critical for heart health.
Taking small steps now can lead to a healthier heart in the future. Stress is inevitable, but how we handle it makes all the difference.”
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