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Chronic Stress Impacts Mental, Physical Health

American Heart Association

Why it matters

  • The COVID-19 pandemic has led to anxiety or depression for many people, and other troubling world events may be adding to their stress.
  • Ongoing stress can lead to mental and physical health problems, including cardiovascular disease
  • Learning ways to manage stress contributes to an overall healthier life.

The COVID-19 pandemic not only caused widespread sickness and death, but it has led to stress and anxiety for many, taking a devastating toll on mental health.

Scientists also know chronic stress can cause physical health problems. It can contribute to heart disease risk factors such as high blood pressure, diabetes, smoking and obesity. Long-term stress is also associated with the risk of cardiovascular disease and some cancers.1

“These health effects were previously known. But COVID-19 has shined new light on the multiple impacts of stress,” said Dr. Nehal N. Mehta, MD, of the National Heart, Lung, and Blood Institute in Bethesda, MD.

“People are on edge. They’re extremely anxious. Their nervous systems are way overactivated,” Mehta said. “It’s important to find ways to manage stress through physical activity, healthy eating and getting plenty of sleep,” he added.

How stress affects mind and body

Psychological stress is part of everyone’s life. It can result from happy events, like starting a new job or moving into a new home, or unhappy events, like family problems or illness. Reactions to stress may include fear, shock, anger, sadness, worry, numbness, or frustration.2

People experience stress in different ways. Sometimes stress shows itself through symptoms like a headache, back strain, or stomach pains. Stress can zap your energy, cause sleep problems or make you feel cranky, forgetful, or out of control. Stress can be linked to negative mental health conditions including anxiety and depression.3

A stressful situation sets off a chain of physical events. The body releases adrenaline, a hormone that can cause your breathing and heart rate to speed up and your blood pressure to rise.3 “When the nervous system is overactivated by stress it can trigger chronic inflammation, a key element in many physical illnesses, including cardiovascular disease,”1 explained Mehta, chief of the NHLBI’s Laboratory of Inflammation and Cardiometabolic Diseases.

Acute stress can last from seconds to weeks, while chronic stress may span months and years. Each person’s physical response determines a stressor’s health consequences, according to a 2020 study in the American Heart Association journal Circulation: Cardiovascular Imaging.1

Stress and troubling world events

Since the COVID-19 pandemic began in 2020, cases of major depressive disorder and anxiety disorder increased worldwide as infection rates increased and the ability to leave home, go to work and school, and socially interact decreased.4

“Studies have shown people with symptoms of depression are at higher risk for cardiovascular events,” Mehta noted.5

Meanwhile, some people who aren’t directly connected to traumatic events may experience stress from observing them from afar.6 The war in Ukraine clearly creates anxiety and post-traumatic stress for those in the war zone. It’s possible witnessing the fighting long distance through media may lead to stress,7 “but it’s too soon to know for sure the war’s effect on people far removed from the battlefield,” Mehta said.

Managing stress, moving forward

There are a number of ways to cope with stress. Exercise, eat nutritiously, and get plenty of sleep. Avoid excessive alcohol and substance use. Go for a walk. Make time to unwind and engage in activities you enjoy.2

Pay attention to your mood. If you are depressed “really take that seriously,” Mehta said.

Consider talking to a counselor, a doctor or someone you trust, such as a friend or a pastor. Try taking a break from watching or reading news stories and social media about stressful events. While it’s good to be informed, hearing constantly about an upsetting situation can negatively impact mental health.2

The American Heart Association, citing research on the cumulative effect of daily stressors and exposure to traumatic events, has issued a scientific statement recommending healthcare professionals consider patients’ psychological health when evaluating or treating people at risk for heart disease. Negative psychological health conditions are associated with a less healthy heart and body and with cardiovascular disease risk.8

The mind, heart and body are all connected. Managing stress can be the first step in moving forward on a healthier path.

Things to consider

  • Taking early steps to cope with stress may prevent anxiety or depression.
  • Find time to exercise, eat nutritiously, and engage in activities you enjoy to keep stress and its effects under control.
  • Chronic stress not only contributes to negative mental health, but it can cause physical illnesses, including cardiovascular disease.


1Disentangling the Links Between Psychosocial Stress and Cardiovascular Disease,” Circulation: Cardiovascular Imaging, August 2020
2Coping With Stress,” Centers for Disease Control and Prevention, November 2021
3Stress and Heart Health,” American Heart Association, June 2021
4Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic,” The Lancet, October 2021
5Association of Symptoms of Depression With Cardiovascular Disease and Mortality in Low-, Middle-, and High-Income Countries,” JAMA Network, June 2020
6Media Coverage of Traumatic Events: Research on Effects,” PTSD: National Center for PTSD, U.S. Department of Veteran Affairs, March 2022
7 Stressed by what’s going on in Ukraine? How to cope – and Help,” University of Michigan Health, March 2022
8Mental health is important to overall health, and heart disease prevention and treatment,” American Heart Association, January 2021


This article was prepared by the American Heart Association (AHA). Transamerica is not affiliated with the AHA and does not control, guarantee, or endorse the information. This information does not constitute the practice of medical advice, diagnosis, or treatment. Always talk to your healthcare provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified healthcare professional immediately. If you are in the United States and experiencing a medical emergency, call 911, or call for emergency medical help immediately.

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