Introduction
In the high‑volatility world of finance, being exposed to stress is a frequent occurrence. But can emotional turbulence from financial markets really affect the heart? Emerging research confirms that financial stress—including losses in investments—may contribute to serious cardiovascular outcomes, up to heart attacks. This article explores whether being stressed might be harming your heart and reviews real studies on financial stress, emotional triggers, and cardiac risk.
In addition, at the end of this article two extra questions will be answered:
- How does STRESS cause a HEART ATTACK ?
- Does WORKING at NIGHT mean a Higher Risk of a HEART ATTACK ?
- Stress, Financial Volatility, and Cardiovascular Health
A meta-analysis published in 2024 Current Problems in Cardiology examined the association between financial stress and risk of major cardiovascular events—such as myocardial infarction (heart attack), stroke, or cardiovascular death. It found that people experiencing financial stress had a 19% higher risk of these major cardiovascular outcomes (i.e., hazard ratio approximately 1.19). The study screened 2,740 studies, ultimately including seven that met prespecified criteria. The pooled hazard ratio (HR) was 1.191 (95% confidence interval: 1.00 to 1.47), with a p-value < 0.001, indicating a statistically significant association. The authors cautioned that the number of studies was small, definitions of financial stress varied, the studies were all from Western countries, and results differed across subgroups.
https://www.sciencedirect.com/science/article/abs/pii/S0146280623005704?via%3Dihub
A second interesting study, published in JAMA Internal Medicine examined older adults—aged 75 and over—recovering from heart attacks. The study included data from nearly 3,000 participants.
They categorized financial strain by self-report:
- No financial strain (“more than enough to make ends meet”)
- Moderate financial strain (“just enough”)
- Severe financial strain (“not enough to make ends meet”)
Findings within six months of hospital discharge:
- Death rate for severe financial strain group: ~16.8%
- Compared to ~9% for moderate strain and ~7.2% for no strain
After adjustment for medical and demographic factors, those under severe financial strain had a 61% higher risk of death within 180 days (hazard ratio [HR] ≈ 1.61; 95% CI: 1.07–2.41) compared to those with no financial strain.
Importantly, the authors noted that this increased risk may stem from reduced access to care—for example, skipping medications or missing follow-up appointments due to financial barriers such as costs or transportation—as well as biological factors like stress-related inflammation.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2788997
Finally, an intriguing study was published in Circulation journal in 2019, which examined income volatility in young adulthood using data from the CARDIA (Coronary Artery Risk Development in Young Adults) cohort. The researchers tracked nearly 4,000 individuals, aged 23 to 35 at baseline, over a 15-year period (1990 to 2005), then assessed cardiovascular outcomes and mortality during the subsequent 10 years (2005–2015). The researchers found, that individuals with two or more significant income drops during those 15 years had:
- More than 2.5 times higher risk of cardiovascular disease (e.g., heart attack, stroke, heart failure) compared to peers with stable income.
- Approximately 92% higher risk of premature death, i.e., nearly double the risk of early death
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.035521
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Biological Mechanisms: How Stress Translates to Heart Damage
2.1 Cortisol and Long-Term Wear
An interesting study from Linköping University in Sweden, found significantly elevated hair cortisol levels (reflecting chronic stress over months) in individuals in the month preceding a heart attack, compared to controls, using 1–3 cm hair samples. Cortisol is a biomarker of long-term chronic stress remained a strong and independent predictor of AMI, even after adjusting for well-known cardiovascular risk factors.
https://pubmed.ncbi.nlm.nih.gov/33384452/
2.2 Mental Stress–Induced Myocardial Ischemia (MSIMI)
A study published in JAMA in November 2021 investigated mental stress–induced myocardial ischemia (MSIMI) and its prognostic implications in patients with coronary heart disease (CHD) — average age approximately 60 years. The research included 918 participants.
Prevalence of Ischemia:
- 16 % of participants experienced mental stress–induced ischemia (MSIMI).
- 31 % showed ischemia during conventional (physical) stress.
- 10 % experienced ischemia in both mental and physical stress tests.
The researchers concluded:
- Among CHD patients (~60 years old), 16 % developed ischemia during a mental stress test (e.g., pressured speech).
- Those with MSIMI alone faced about double the risk of heart attack or heart failure.
- Those with both MSIMI and physical stress ischemia had a fourfold increase in risk compared to those without either type of stress-induced ischemia.
- Stress-Related Disorders and Heart disease
A large Swedish population-based, sibling-controlled cohort study, published in The BMJ in 2019, examined the risk of cardiovascular disease (CVD) following diagnoses of stress-related disorders—including post-traumatic stress disorder (PTSD), acute stress reaction, adjustment disorder, and other stress reactions.
The study included:
- 136,637 individuals with diagnosed stress-related disorders,
- 171,314 unaffected full siblings,
- 1,366,370 matched unexposed individuals from the general population.
The authors concluded:
- Individuals with diagnosed stress-related disorders had a 64% higher risk of cardiovascular disease during the first year after diagnosis (HR ≈ 1.64).
- This risk fell to approximately 29% higher (HR ≈ 1.29) after one year.
- For certain subtypes like heart failure and arterial thrombosis/embolus, HRs reached as high as ~2–7× compared to unaffected siblings.
https://pubmed.ncbi.nlm.nih.gov/30971390/
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“Broken‑Heart” Cardiomyopathy
Extreme emotional stress can even trigger takotsubo cardiomyopathy, also known as “broken‑heart syndrome.” Often following sudden grief or trauma, this effect involves temporary weakening of the heart muscle. Frequently this is triggered by emotional stressors like bereavement, abrupt job loss or relationship breakups. While rare, this provides a stark example: emotional turmoil—not physical exertion—can itself initiate serious cardiac dysfunction.
We will describe Takotsubo Cardiomyopathy in more details in near future on our blog https://drbart.co.uk/blog/.
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Empirical Evidence: Stress and Heart Attacks Connected – High Perceived Stress + Life Adversity = Higher CVD Risk
An international cohort study, published in JAMA in 2021 and led by the University of Gothenburg, using data from over 118,000 individuals, found that higher levels of perceived stress, financial strain, and adverse life events were strongly linked to elevated rates of heart attacks and strokes.
Over a median follow-up of 10 years, the study tracked incidents of myocardial infarction, stroke, and heart failure—totalling 5,934 cardiovascular events.
After adjusting for traditional risk factors (age, sex, education, marital status, region, abdominal obesity, hypertension, smoking, diabetes, and family history of CVD), the researchers observed:
- Individuals with high stress vs. no stress had:
- 22% higher risk of any CVD event
- 24% higher risk of heart attack
- 30% higher risk of stroke
These findings strongly suggest that psychosocial stress—including perceived stress, financial strain, and adverse life events—is an independent and significant predictor of cardiovascular disease worldwide.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787178
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Mitigating Risk: What Investors Can Do
5.1 Stress Management Techniques
Quick Breaks in Nature or Movement Reduce Stress Hormones
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Nature exposure:
- A review covering 14 studies (including sitting or walking in green spaces) found just 10–20 minutes can significantly reduce stress and enhance psychological well-being.
https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2019.02942/full
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- Another study showed that walking in a forest significantly lowers salivary cortisol, whereas urban walking does not.
https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2019.00376/full
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- A recent study in Vienna confirmed that just 20 minutes in a forest produces measurable relaxation effects.
https://www.mdpi.com/1999-4907/16/5/792
Short Breathing Exercises Ease Anxiety, Lower Blood Pressure
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Diaphragmatic (deep) breathing:
- An 8-week intervention with guided diaphragmatic breathing resulted in significantly lower cortisol levels and improved attention in healthy adults.
https://pubmed.ncbi.nlm.nih.gov/28626434/
More about deep breathing in our blog post below:
https://drbart.co.uk/can-deep-breathing-lower-blood-pressure-in-minutes/
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Nighttime routine.
The American Heart Association emphasizes the importance of a consistent bedtime routine as part of its “Life’s Essential 8” framework for cardiovascular health. These routines—including winding down without screens, engaging in mindful activities (like reading or deep breathing), and going to bed at regular times—promote better, restorative sleep and support overall heart health.
Conclusion
While crypto markets may feel detached from physical health, the psychological stress may be connected to heart disease. Investors, especially in high-stakes and volatile markets, should be mindful: the stress and heart attack link is connected to non randomised research—ranging from hormonal biomarkers to clinical outcomes.
Final two questions:
How does STRESS cause a HEART ATTACK ?
– A study from May 2023 showed us links between STRESS-related neural activity in Amygdala and:
– Coronary inflammation
– Intracoronary plaque vulnerability
– Bone marrow activation.
– In addition to this Activation of Amygdala was associated with Major Adverse Cardiovascular Events (Heart attack, Heart death and Hospitalisation for unstable angina)
– It was a study, which recruited 299 individuals between 2013 and 2020 and was published recently in JACC: Cardiovascular Imaging.
– STRESS-related neural activity increase risk of Major Adverse Cardiovascular Events 17.2% vs 5.1%, HR 3.22, p=0.011.
– Coronary inflammation (fat attenuation index) and high risk intracoronary plaques were assessed by PET/CT/CTCA and were found to be linked to Activation of Amygdala, r=0.49, p<0.001 and 40.7% vs 23.5%, p=0.002, respectively.
Link to article below:
https://www.jacc.org/doi/epdf/10.1016/j.jcmg.2023.04.004
Does WORKING at NIGHT mean a Higher Risk of a HEART ATTACK ?
– According to a study published in August 2022 in Heart, NIGHT SHIFT WORK was associated with a higher incidence of ISCHAEMIC HEART DISEASE.
– For WOMEN the Hazard Ratio was 1.25 (95% CI 1.17-1.34) and for MEN the Hazard Ratio was 1.10 (95% CI 1.05-1.14).
– It was a huge study, which included over 800k male and over 700k female particpants in New Zealand, age 20-64 years old, between 2013 and 2018.
– This study also looked at working long hours and sedentary work, but no association was found.
– Interestingly, the researchers studied loud noise (>90 dBA) and found modestly higher risk of Ischaemic Heart Disease in MEN (HR 1.19, 95% CI 1.07-1.33).
Link to the article below ⬇️:
https://heart.bmj.com/content/heartjnl/109/5/372.full.pdf
The Authors concluded:
‘This study suggests that occupational exposures to high levels of noise and night shift work might be associated with Ischaemic Heart Disease risk’
