Social Stress and Job Strain Increase Women's Risk of Heart Disease, Study Says

Dealing with stress from work and your social life can do more than just give you a headache—it may also increase your risk of coronary heart disease, new research shows.

In a study recently published in the Journal of the American Heart Association, researchers looked at data on more than 80,000 women collected over a total of 22 years. They found that women who were dealt a double blow of social strain and job strain were 21% more likely to develop coronary heart disease, the leading cause of death in the United States.

Here are the latest findings on stress and heart disease, and what they could mean for overall heart health as we recover from the challenges of the pandemic.

Stress Increases Risk of Heart Disease

For the study, researchers used data on 80,825 participants in the Women’s Health Initiative Observational Study, a long-term study on a nationally representative group of postmenopausal women. Participants ranged in age from 50 to 79 and were about 63 years old, on average, at the start of the study. The study lasted from 1991 to 2015 and included multiple follow-ups with participants.

The researchers looked at three sources of psychosocial stress, which happens when you struggle to cope with challenging environments.

To learn about psychosocial stress from work, the researchers used details from the Occupational Information Network to calculate the job demand and job control participants faced in their most recent paid positions. Jobs that give people little control and have high demands are generally considered to be more stressful.

Researchers evaluated participants’ psychosocial strain from stressful life events through a questionnaire. It asked the participants about their experience with 11 major life events, such as the death of a spouse, major financial problems, divorce, job loss, and physical and verbal abuse, over the previous year, and to what extent those situations cased them distress.

The participants also answered questions about their social relationships, such as the number of people who irritate them, ask too much of them, or exclude them from events, so researchers could score their level of social strain.

Finally, the researchers tracked how many participants experienced coronary heart disease using self-reported information verified with medical records and death certificates. A total of 3,841 participants, or nearly 5% of the group, developed coronary heart disease at some point during the study.

The results showed that high levels of job strain and social strain together increased participants’ risk of coronary heart disease by 21%. Stressful life events alone pushed the risk up by 12%, while social strain individually caused a 9% spike in the likelihood of coronary heart disease.

“We’re always concerned about the way stresses in our lives impact our hearts. This study further supports that concern,” says Laxmi Mehta, MD, cardiologist and director of preventative cardiology and women’s cardiovascular health at The Ohio State University Wexner Medical Center.

She adds that while men did not participate in this study, it’s likely that they too would experience a higher risk of coronary heart disease from stress.

“I think men are in the same boat, but we don’t know the percentages. We can’t say that men will be fine and they won’t suffer from life stresses or job strain,” says Dr. Mehta.

The report advances earlier research by figuring out which types of psychosocial stress cause the biggest increase in a person’s risk of coronary heart disease.

“This study is unique in the sense that it tries to assess the effects of three important psychosocial stressors in a woman’s life, including job strain, stressful life events, and social strain,” says Rashmi Parmar, MD, psychiatrist with Community Psychiatry. 

Understanding the Effects of Stress

The link between stress and heart disease had already been established prior to the conclusion of this research, the study authors say.

“Physiologically, when our bodies perceive stress, the stress hormone cortisol is released, which, in turn, increases heart rate and blood pressure in preparation for our body’s defense against a threat,” explains Desreen N. Dudley, PsyD, a licensed clinical psychologist at Teladoc, which provides virtual healthcare.

That can cause damage to the endothelium, a membrane inside of heart and blood vessels, potentially leading to a build-up of plaque that causes coronary heart disease.

Stress may also have an indirect impact on our heart health, as it can often nudge us away from healthy behaviors, experts say.

“People may cope with stress with unhealthy habits, like drinking excessive alcohol or smoking cigarettes, which can cause strain on the heart,” says Dr, Parmar.

Coronary heart disease caused nearly 366,000 deaths in 2017, according to the most recent data available from the Centers for Disease Control and Prevention (CDC). With many people facing higher stress levels during the pandemic, some experts worry that we may see even higher rates of heart disease in the coming years.

“This is an even bigger issue right now in the time of COVID. There’s lots of job strain and social strain, especially in healthcare workers and frontline workers, who [face] high demands and have low control of their workload,” says Dr. Mehta. “Who knows what things will look like in five to 10 years from now, considering all the stresses we’re going through?”

Tips to Reduce Stress in Your Life

From arguments with loved ones to tight deadlines at work, stress is often an unavoidable part of life. However, there are ways to manage it and reduce its effects on your physical and mental health.

The first step is noticing when you’re feeling stressed and how it’s affecting you. Look out for physical symptoms, such as increased heart rate, muscle tension, and sweating, along with emotional changes, like sadness, irritability, anger, or feeling overwhelmed, says Dr. Dudley.

When you experience signs of stress, try to take steps to combat it immediately and throughout your life.

• Make self-care a priority. “This is a major step towards overall stress reduction. Make sure you are getting timely meals, adequate sleep, enough exercise, and leisure time during your day,” says Dr. Parmar.
• Get enough sleep (usually about seven to eight hours). “Like we teach our kids, follow a regular bedtime routine to get sufficient amount and quality of sleep. Good rest rejuvenates the body and mind,” says Dr. Dudley.
• Tap into your support network. “Keep yourself connected with family, friends, and coworkers who are supportive and meaningful in your life,” says Dr. Parmar.
• Practice mindfulness and meditation. “There are many easy-to-learn routines for meditation and mindfulness practices, including guided imagery, deep breathing, and progressive muscle relaxation, which are accessible online,” says Dr. Dudley.
• Make time for enjoyable, relaxing activities. “Engage in pampering or self-soothing activities from time to time, such as getting a massage, soaking in a hot bath, catching up with a friend, or engaging in an enjoyable hobby,” says Dr. Parmar.

If these techniques don’t seem to lower your stress levels, or you’re overwhelmed by a particularly stressful situation, you might want to consider seeking support from a mental health professional. They can help you learn other healthy coping mechanisms that will not only benefit your emotional wellbeing, but also potentially add a layer of protection for your heart health.