For some adults with heart disease, stress can increase the risk for a cardiac event

A man wearing a suit holds a microphone as he prepares to give a public speech

Does the thought of public speaking make you nervous? If so, you’re not alone. Researchers picked this activity to mimic the impact a mental stress-inducing event may have on the cardiac function of older adults with controlled heart disease. Out of a 918-person study, one in six adults experienced a cardiac response to this type of stress – specifically where the coronary arteries tighten or restrict and limit blood flow to the heart. Adults who had this reaction were more likely to have an increased risk for a cardiac-related event, like a heart attack, compared to adults who didn’t have the same physical response to stress.   
As part of the analysis, researchers evaluated how the hearts of adults in this study responded to mental stress, in this case public speaking, or physical stress, such as exercise-induced stress after a treadmill exercise. After both 
stress tests, 16% of patients had a mental stress-induced cardiac response, 31% had a physical stress-induced cardiac response, and 10% experienced both. Researchers followed patients for five years and tracked adverse outcomes, including cardiac-related deaths, nonfatal heart attacks, and heart failure. They found mentally stressful events that led to coronary artery constriction were associated with a greater risk for a cardiac event, but physical stress didn’t have the same impact. However, participants who experienced cardiac responses to both types of stress had an increased risk for a cardiac event. The researchers conclude more research is necessary to pinpoint mechanisms underlying these responses as well as the potential benefits of testing and interventions 

The study published in JAMA and was funded by the NHLBI, the National Institute of Mental Health, the National Center for Advancing Translational Sciences, and the National Institute of Child Health and Human Development.