Genes Can Increase Heart Attack Risk in Stressful Times

Stress affects everyone in different ways, and we each have our own methods for getting through it. But did you know that there’s a connection between stress and heart health? 

According to the Centers for Disease Control and Prevention (CDC), chronic stress and mental health conditions like depression and anxiety are associated with heart disease risk. Even more worrisome, heart attacks are more common around certain times of the year, like the winter holiday season. 

Now, a new Mass General Brigham study reveals that your genes can contribute to your risk of heart attack during periods of high stress. The researchers report that people with specific genetic traits, especially when paired with anxiety or depression, have a higher risk of heart attack during stressful times like the holidays, political elections, and sporting events. 

“Our findings suggest that genetic screening could help us identify people at higher risk of heart attack from stress,” says Shady Abohashem, MD, MPH, a Mass General Brigham researcher and an instructor of cardiovascular research at Massachusetts General Hospital. Dr. Abohashem was lead author on the study and presented their findings at the American College of Cardiology’s 2024 annual scientific session. “We could intervene earlier and develop prevention strategies for those at high risk to help reduce their stress.”   

How can certain genes and stress cause heart problems? 

Not only can you have genetic risk factors for heart attack, genetics also predispose some people to higher levels of stress. In other words, genes—the unique “code” we’re born with that makes each of us who we are—affect how we respond to stress, which can have an impact on our health. 

This is the first study to examine if genes and stress sensitivity can cause acute coronary syndromes (ACS). ACS events include heart attacks and other serious conditions where the heart doesn’t get enough blood. Their research is based on data collected from the Mass General Brigham Biobank, a research program that aims to help understand how genes, lifestyle, and environment affect people’s health.  

Stress and heart attack risk during holidays, presidential elections, and sporting events

Over a 20-year period (2000 – 2020), they identified 1,890 participants who experienced an ACS event. Of those participants, those with above average nPRS were 34% more likely than others to experience an ACS event during a stressful period than at other times.  

The researchers also report:

• Participants with higher nPRS were more likely to have anxiety and depression.
  
• Participants with above average nPRS and anxiety or depression were 3.2 times more likely to experience an ACS event during a stressful period compared to calmer times.

Screening for anxiety and depression to identify risk of heart attack from stress 

“People who are genetically predisposed to stress have a much higher probability of heart attack after a stressful event,” Dr. Abohashem observes. “Those genetics, especially when coupled with anxiety or depression, increase your risk of heart attack substantially.” 

While genetic screening may not be feasible for all patients, Dr. Abohashem says that screening for anxiety and depression is possible at most clinics and would help identify patients at higher risk of an ACS event. Patients with anxiety or depression could then work with their health care team to find better ways of coping with stress and managing their mental health condition.

Tips for managing stress to reduce risk of heart problems 

It’s important to be aware of the impact of stress on heart health. Stress and certain mental health conditions can contribute to lifestyle behaviors that increase your risk of heart problems, including:

• Smoking
  
• Overeating or eating an unhealthy diet 
• Drinking excessive amounts of alcohol
• Lack of exercise
• Not taking medication as prescribed  

There are many different factors that cause stress throughout life, some of which are completely out of your control. Whether your genetics predispose you to high stress or not, it’s important for your overall health to manage your stress in positive ways. 

Lifestyle changes to help with stress and heart health 

Making changes to your lifestyle can help reduce the amount of stress in your life and improve your heart health at the same time. Here are a few tips to help you better manage your stress:  

• Quit smoking. Get tips to quit smoking. Not only will quitting lower your risk of certain heart conditions, it also increases your life expectancy and reduces risk of stroke, cancer, and COPD.
  
• Get more sleep. Stress can make restful sleep difficult. But there are small behavior changes, like having a routine and keeping your room cool, that can help you sleep better and wake up feeling more rested.   
• Try meditation. This practice can help you stay in the present moment and achieve a clearer, calmer mental state to reduce your anxiety and stress. Studies show that over time, meditation can change your brain’s reaction to emotional or negative stimuli. 
• Exercise regularly. Physical activity has several benefits for your overall health and is known to reduce stress and improve mood. Regular exercise, like strength training, can help lower your blood pressure and keep your arteries healthy.
  
• Talk with friends and family. Maintaining connections with people you trust is especially important during times of stress.  
• Try a new hobby. Keep yourself engaged with a hobby like baking or crafting to avoid negative thoughts and worries that might pop up during your free time.
  

Talk to your health care provider about medication or therapy for stress 

You might still feel overwhelmed by stress at times, even if you make positive changes to your lifestyle—especially during the holidays or other stressful periods. If you have anxiety or depression, it’s even more important to manage those conditions and do what you can to improve how you handle stress. 

If lifestyle changes aren’t helping, talk to your doctor about other options to help with your mental health. They may recommend:

• Stress management classes 
• Therapy. Meeting with a mental health care provider can be helpful to share your feelings and talk through new ways of coping with stress. 
• Medication. Your doctor may discuss different types of medication to help with anxiety or depression. You may need a combination of therapy and medication to understand and address the root cause.  

Know the warning signs of a heart attack. 

During times of higher stress, like the holiday season or upcoming presidential election, it’s important to stay in tune with how you’re feeling. There are several warning signs of a heart attack that are easy to recognize if you know what to look for. 

Signs and symptoms of a heart attack include:

• Chest pain or pressure
  
• Shortness of breath
  
• Cold sweat even when at rest
  
• Weakness or light-headedness
  
• Pain or discomfort in the neck, back, jaw, arms, or shoulders

For women, other symptoms include nausea and abdominal pain and cramping. Call 9-1-1 right away if you think you might be having a heart attack.

A heart attack is a serious condition, but there are steps you can take to reduce your risk. The study led by Dr. Abohashem, and his colleagues suggests staying more vigilant when it comes to your mental health during high-stress periods, and making positive lifestyle changes to manage your stress can help reduce your risk of heart attack and other heart conditions.