Stress and Atherosclerosis

Stress is the body's response to situations it sees as challenging or threatening. It may increase the risk of atherosclerosis, although the link is harder to study than for smoking or diet.When a person is stressed, the adrenal glands release the hormones adrenaline and cortisol (the fight-or-flight response).Adrenaline increases heart rate and causes arterioles to constrict. Both effects raise blood pressure. Cortisol raises blood glucose concentration.These responses are useful for short periods, but chronic (long-term) stress keeps blood pressure raised for long periods. High blood pressure damages the endothelium of the arteries, which is the first step in atheroma formation. Raised pressure also makes the heart work harder.Stress can also raise the risk indirectly, because some people cope with stress by smoking, drinking more alcohol or eating more high-energy food. Each of these is a risk factor in its own right.Stress is difficult to investigate because it is hard to measure objectively: people react differently to the same situation, and studies often rely on questionnaires. It is also hard to separate the effect of stress from the behaviours linked to it, so a correlation between stress and CVD does not prove that stress itself is the cause.