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Manage stress through exercise, sleep, and social time

American Heart Association

Why it matters

  • Stress can contribute to high blood pressure and unhealthy behaviors that increase heart disease risk.
  • New work environments during COVID-19 may have intensified job stress.
  • Job stress affects individual health and increases healthcare costs and absenteeism at work.1

Job stress was around long before COVID-19, and then the pandemic created new demands for many Americans. They had to adapt to a changing work world while facing fear and grief.

Work-related stress costs money through employee healthcare and absenteeism,1 so many corporations are now paying attention to employees’ mental health.2 Stress also affects people’s overall health and well-being.

Scientific research increasingly shows that psychological health is connected to physical health. Furthermore, psychological stress may be causally linked to cardiovascular illness.3 “It may contribute to heart attacks, high blood pressure, and heart disease,” said Dr. Glenn Levine, M.D., master clinician and professor of medicine at Baylor College of Medicine and cardiology section chief at the Michael E. DeBakey VA Medical Center in Houston.

A “mind-heart-body” connection explained in an American Heart Association statement Levine chaired notes that chronic stress is one of several negative psychological conditions that can impact heart health. Others are anxiety, depression, anger, pessimism, and dissatisfaction.3 

Types of stress

Acute, or severe, psychological stress may arise from natural disasters, like an earthquake, or from war or the death of a loved one. Chronic stress is ongoing and can be related to day-in, day-out problems including marital or work difficulties.4

Stress can make your body release adrenaline, temporarily causing your breathing and heart rate to speed up and blood pressure to rise. Stress can also contribute to behaviors and conditions that increase heart disease and stroke risk, such as smoking, overeating, being physically inactive, and being overweight.5  

Many adults spend half of their waking life at work. A review of multiple studies concluded work stress increased the risk of heart disease and stroke by 10% to 40%.4

One-third of American workers report high levels of stress. Excessive workloads, tedious or meaningless tasks, long hours, low pay, and unreasonable performance demands and deadlines contribute to job stress. Favoritism, lack of recognition, inflexible rules, and job insecurity are other contributors.6

COVID-19 pandemic and stress

Work environments changed drastically when the COVID-19 pandemic took hold in early 2020. “There isn’t yet much data on the pandemic’s effect on job stress and how that impacts cardiovascular health,” Levine said. He predicted it will take a few more years before results of scientific studies emerge.

“Clearly, COVID has the potential for increasing stress and negatively impacting psychological health,” he said. “It led to social isolation, depression, and a reduction in the normal social support system many people depend on.”

Even before the pandemic, mental disorders were the top causes of the global health-related burden. COVID-19 exacerbated the problem, potentially affecting mental health through lockdowns, business closures, and loss of livelihood.7

Financial costs of job stress

Job stress is estimated to cost American companies more than $300 billion a year in healthcare expenses, absenteeism, and poor performance. Stress is the cause of 40% of job turnover. Replacing an average employee costs 120% to 200% of the salary of that position.1

Today, more U.S. companies are paying attention to workers’ psychological stress out of necessity, but more work is needed, according to the Harvard Business Review. Since the pandemic, some are providing extra paid time off, company-wide mental health days, and mental health training. Some offer more frequent breaks and time off for therapy appointments.2 Supervisors can lead by example by making their own health appointments a priority.8

“It’s good that employers are implementing programs focusing on workers’ physical and mental health,” Levine said. “But a holistic approach is best to ensure the benefits go beyond just improving worker productivity and rather spill over to life in general.”

The American Heart Association, through its CEO Roundtable, evaluates and shares best practices with employers about workplace health. The aim is to model a healthy lifestyle and foster a culture of health.9

Managing stress

Doctors can do their part to initiate help for patients who are experiencing chronic stress and other mental health problems. Cardiac healthcare providers aren’t necessarily trained to treat mental health. “However, they can perform simple screenings and be aware of signs of severe stress or depression and offer to refer a patient to a mental health expert,” Levine said.

Individuals can take steps to manage their stress. Exercise regularly and consider a nature walk, meditation, or yoga. Make time for family and friends, get enough sleep, practice relaxation techniques,  or find a stimulating hobby to distract you from negative thoughts.5 

To maintain cardiovascular health and reduce the risk of heart disease, stroke, cancer, dementia, and other major health problems, consider adhering to the AHA’s Life’s Essential 8™, a few easy steps toward a healthier life. They are eating better, being more active, quitting tobacco, getting sufficient sleep, managing weight, controlling cholesterol, managing blood pressure, and managing blood sugar.

“Be aware that improving psychological health may decrease cardiovascular disease risk, and a positive mental outlook may provide some heart-health protection,” Levine said. “But more studies are needed.” Optimism, gratitude, and a sense of purpose have been associated with cardiovascular benefits.3 And that could boost overall health.


1 “Financial Costs of Job Stress,” University of Massachusetts at Lowell, 2022

2It’s a New Era for Mental Health at Work,” Harvard Business Review, October 2021

3Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association,” American Heart Association, January 2021

4Psychological Stress and Heart Disease: Fact or Folklore? The American Journal of Medicine, March 2022

5Stress and Heart Health,” American Heart Association, June 2021

6What is Job Stress?” University of Massachusetts at Lowell, 2022

7Global 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

8 Report: High Employee Burnout Rates Impact Productivity,” CBIA, February 2022

9CEO Roundtable,” American Heart Association, 2022

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