Heart Conditions

Does Stress Increase the Risk of Hypertension and Cardiovascular Problems?

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All of us feel stressed from time to time. Stress is the reaction generated by the brain and body when someone feels overwhelmed or is unable to cope with mental or emotional pressure. Any type of challenge - everyday obligations, work-related pressures, not getting an adequate amount of sleep, having an illness, relationship problems, death of a loved one - can lead to stress.

Stress is often accompanied by the release of certain hormones that are responsible for physical symptoms associated with stress. Long-term or chronic stress can be harmful to the body. According to a new study, higher levels of stress can increase one’s risk of high blood pressure and cardiovascular events such as heart attack or stroke.

How does stress affect the body?

The human body’s biological response to stress is quite complex. It involves the release of cortisol, the primary stress hormone, by the adrenal glands. The main function of cortisol is to help the body react during stressful events. The hormone triggers an increase in energy levels by shooting up blood glucose levels, enhances the use of glucose by the brain, and suppresses non-essential functions.

Besides cortisol, catecholamines are also released in response to emotional or physical stress. Catecholamines are a type of neurohormones (hormones that also function as neurotransmitters) that are produced in the brain, nerve tissues, and adrenal glands. Dopamine, epinephrine (adrenaline), and norepinephrine (noradrenaline) are the three types of catecholamines.

Dopamine plays a key role in regulating movement, emotions, and memory. On the other hand, epinephrine and norepinephrine are responsible for the fight or flight response of the body. When exposed to a perceived threat, the body releases epinephrine to allow increased flow of blood to the muscles, heart, and lungs. Norepinephrine helps elevate heart rate, blood pressure, and the ability to concentrate.

During a stressful event, the body has higher than normal levels of these hormones. While stress response is beneficial in the short term, continued or chronic stress can increase the risk of health issues such as hypertension (high blood pressure), heart disease, stroke, or heart attack. Over time, chronic stress may also make an individual prone to unhealthy coping mechanisms that might put them at an increased risk for poor physical health.

About the study

The study titled Urinary Stress Hormones, Hypertension, and Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis was published in Hypertension, an American Heart Association journal, on 13 September 2021. The objective of the study was to understand the correlation between higher levels of stress hormones and increased risk of hypertension and cardiovascular events.

The study included 412 adult participants (age group - 48 to 87 years) with no medical history of hypertension. It took into account factors such as participants’ sex, education level, income, and health insurance status. Other details like alcohol intake, smoking, and levels of physical activity were also considered. Finally, scientists examined the health status of the participants, including whether they had an underlying medical condition such as diabetes, usage of any medication, body mass index, and kidney function.

The research was part of a larger study called the Multi-Ethnic Study of Atherosclerosis (MESA). As part of their research, scientists asked a subset of participants from the larger study with no cardiovascular disease to participate in an overnight urine collection. The collected urine was then analyzed for levels of epinephrine, norepinephrine, dopamine, and cortisol. 

Once the analysis was over, the researchers enrolled participants who had no hypertension. The participants were followed up for an average of 6.5 years to evaluate hypertension. During the follow-up, 48.8% of participants were found to have developed high blood pressure. Over the average follow-up of 11.2 years, 5.8% of participants experienced cardiovascular events such as heart attacks, stroke, coronary heart disease, and peripheral vascular disease.

Study findings summary

Using scientific research models, researchers calculated the risk of hypertension and cardiovascular events associated with stress hormones. They found that higher levels of stress hormones in the urine are linked with a greater risk of hypertension. Researchers noted that the association was stronger among younger individuals than among older individuals. They also observed that a double than normal level of cortisol in urine may be tied with a higher incidence of cardiovascular events. However, they couldn’t identify any correlation between higher levels of catecholamines and cardiovascular events.

According to the study researchers, the study took into account several factors and included a diverse mix of participants. However, they acknowledged that the study had certain limitations. There was a possibility for errors in specimen collection, sample bias, and unaccounted influencing factors.

Ways to ease stress

Despite its limitations, the findings highlight the significance of managing psychological stress to prevent long-term complications such as hypertension and cardiovascular problems. Individuals who are at an increased risk of chronic stress can take the following measures to improve their mental and physical well-being:

  • Exercise daily
  • Follow a well-balanced and nutritious diet
  • Quit smoking
  • Avoid caffeinated beverages
  • Limit intake of alcohol
  • Practice relaxing techniques such as meditation, deep breathing, yoga, etc.
  • Listen to soothing music
  • Take out time for favourite activities and hobbies.


Everyone experiences stress every now and then. Stress is a physical, mental, or emotional reaction of the body to pressures from certain situations or events. Normally, it is nothing to worry about much. However, long-term or chronic stress can make an individual susceptible to health conditions like hypertension and cardiovascular problems. To prevent the likelihood of chronic stress, one should try to lead a healthy and active lifestyle. Following stress-busting techniques and avoiding common triggers can also help an individual deal with stress. Those who still feel stressed should consult a healthcare professional to know more about treatment options.

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