Stress causes all sorts of minor physical discomfort—think sweaty hands and an upset stomach. But it can also raise your risk of serious heart problems, says Johns Hopkins cardiologist Michael Blaha, M.D., M.P.H., who frequently offers his patients advice on how to keep stress from threatening their heart health.

Perhaps the most surprising part of the connection is that stress can pop up in many different scenarios—from relationships to “good” jobs to sporting events. And all can take a toll on your heart health.

Recognize Stress Sneaking In

Going through a divorce can be quite stressful, but until recently researchers didn’t know how long the health effects of that stress might last.

In a recent study that followed participants over 18 years, women going through two or more divorces had a rise in heart attack risk that was similar to that of a smoker or a person with diabetes. The study found a higher heart attack risk in men who’d had multiple divorces too. Though men did see a health benefit from remarriage, women did not. Even decades after a divorce, relationship stress can leave a powerful imprint on your health.

Work-related stress can also harm your heart. Research has found that people who are more worried about losing their job are nearly 20 percent more likely to have heart disease. “But people who are happy in their jobs may be chronically stressed as well because of the competitiveness of their jobs or because they’re trying to balance their work and home life,” Blaha says.

Surprisingly, even stress related to enjoyable events may raise your risk of a heart emergency. During a recent World Cup soccer event, heart attacks more than doubled in one German city during days when the nation’s team was playing.

Stress and Heart Disease: What’s the Link?

Stress can increase inflammation in your body, which in turn is linked to factors that can harm your heart, such as high blood pressure and lower “good” HDL cholesterol, Blaha says.

But chronic stress can also affect your heart in a more indirect way. When you’re worried, you tend to sleep poorly. You’re also less likely to exercise, make healthy food choices, or watch your weight, Blaha says. All of these lifestyle changes can put your heart health at risk.

How to Protect Your Heart

“Too often, people consider their stress as almost separate from their health,” Blaha says. If you’re struggling with any kind of stress, recognize that it can have harmful consequences. These steps can help you protect your heart during stressful times:

Get professional advice. Discuss your stress levels with your health care provider. This is especially important if you have other risk factors for heart disease, such as obesity or high blood pressure, Blaha says. Sometimes, just talking with your doctor can convince you to change your lifestyle.

Let stress motivate you. Turn stress into a reason to exercise instead of using it as an excuse to avoid physical activity, Blaha recommends. “When you have a stressful day, taking a break to walk with friends over lunch can take your mind away from the grind,” he notes.