For decades now the medical community has focused on stress as a major cause of heart disease. But is that a fact? Has the negative impact of stress been overblown, especially when compared to other risk factors? After all, stress is a normal part of our everyday life. What’s really important to consider is the type and amount of stress – and how we react to it.

Good vs. Bad Stress

Good stress can lead to motivation and self-fulfillment. It’s the type of stress students feel when taking an exam or workers experience when pushing to meet a deadline. Bad stress, by contrast, occurs when people feel overcome with worry. This stress emerges from life-changing events, such as a debilitating illness, unemployment or relationship problems.

Risk Factors

Responding to stress properly can reduce the risk of heart disease. Being overstressed can cause actual physiological changes in the body, affecting the function of blood vessels and autonomic nervous system. Leaving stress unmanaged can also lead to depression, doubling the risk of heart disease. Social isolation is a related risk factor that often affects those who live alone, are lonely or lack a good support system. People in social isolation and those who suffer from depression often don’t eat right, pick up a smoking habit and neglect exercise — behaviors that can increase your risk of cardiac issues.

Type A Personality

For years, people who were overly stressed with time urgency were labeled as “Type A Personality.” The term Type A personality was coined in the 1950s by two physicians who linked the Type A personality behaviors as a cause of heart attacks. But many of their conclusions were based on flawed studies sponsored by the tobacco industry in its attempt to deflect attention away from growing proof of the dangers of smoking. Ads at the time even promoted smoking as a positive way to combat stress, claiming smoking “calms you down when you’re tense!”
The fact is anyone who is consistently stressed because of illness, worry or depression is at higher risk of developing heart disease. However, this behavior is not as dangerous as smoking or diabetes.


The best predictor of asymptomatic coronary heart disease is through measuring calcified plaque in blood vessels of the heart. North Kansas City Hospital uses a screening test to determine a coronary calcium score. The test is quick, painless and costs $50. Visit or call 816.691.5267 for more information. The test can be especially helpful in identifying heart disease in women because their symptoms and even their plaque is different.


Many risk factors contributing to heart disease are preventable. Steps you can take include:

  1. Stop Smoking!
    Smoking puts you at the highest risk for heart disease. In Missouri about one out of four men and women smoke. And when smoking is combined with a family history of premature heart disease, it’s an especially lethal combination.
  2. Maintain a Healthy Diet
    Adopt a heart-healthy diet that includes limiting salt intake. If your entire family adopts healthier eating habits along with you, your chance of success will be much higher.
  3. Exercise Regularly
    Depending on your age, the recommendation is for regular exercise at least four to five times per week for 30 to 40 minutes each session. You should reach the point where you become breathless or break out into a sweat. Spreading out your exercise over a week is much better than extensive sessions less frequently.
    Running, walking and swimming (whatever exercise you’ll do consistently) are all good activities. Pick an exercise you enjoy and commit to an ongoing routine.
  4. Seek Help for Depression
    In addition to increasing the risk of heart disease, depression often causes individuals to adopt unhealthy habits, such as smoking more and not eating right or exercising. Getting timely help to treat depression can be a lifesaver.
    You can reduce the effects of bad stress by adopting healthy habits, building a support system and seeking help when you need it. The goal is not to avoid stress in life, but to respond to both good and bad stress in positive ways.

Farrar_MichaelMichael Farrar, MD, is a cardiologist with Meritas Health Cardiology at North Kansas City Hospital. He specializes in treating cardiovascular disease, including valvular heart disease, hypertension, atrial fibrillation, syncope, transesophageal and echocardiography.
To schedule an appointment with Dr. Farrar, please call 816.221.6750.