Many people believe that stress is a leading cause of heart attacks. When your doctor evaluates your risk for a heart attack, he or she can measure your fitness and your nutritional status objectively, and can tell you about hundreds of studies on the effects of diet and exercise that are based on solid science. But stress is subjective, not clearly defined or measurable. What one person considers stressful may be a motivating source of success to another. A situation that causes you great distress may be just a minor annoyance for someone else, and vice versa. We dont have any reliable way to measure stress and we dont even have a universally accepted definition of what constitutes stress or elimination of stress.

Several studies associate stress with increased risk for heart attacks, and one study from Duke University showed that stress reduction techniques reduced second heart attacks (American Journal of Cardiology January 15 2002). If you and your doctor think that you may benefit from any of the stress management techniques, by all means use them, but ADD them to your diet changes and fitness efforts. Stress management programs may include meditation, classroom teaching about heart disease and stress, training in stress-reduction skills, anger management, group support, yoga or Tai Chi classes and/or tranquilizing medications.

Its my personal belief that telling patients their health problems are caused by stress is an example of "blame the victim." Theres no doubt that your physical health and your overall happiness are intimately connected. If YOU are dissatisfied with your work or your personal relationships, if you do not have fulfilling interests and a sense of purpose, your health may well suffer. But if I AS YOUR DOCTOR tell you your problem is caused by stress, its often because I cant find any other physical explanation and dont want to admit "I dont know." I KNOW you can improve your heart health with diet and exercise; thats why I suggest focusing on these tangible changes. Good food choices and vigorous exercise are two of the best ways we have to combat "stress", improve your mood, help you sleep better and feel better about yourself. Seeking counseling and changing your spouse, job or environment may reduce your stress and thus help you to prevent heart attacks or strokes. Depression and panic attacks are treatable medical conditions that can increase your risk for heart attacks; if you suffer from either of these, please check with your doctor.