It’s no secret that stress taxes your emotions and can take a toll on your physical health. If you’re juggling a career with family life, raising kids or caring for aging parents, you may feel overwhelmed. Even positive things, like planning a vacation or moving to a dream house, can heap stress onto your plate. While you may not be able to get rid of all the stress in your life, you can take steps to reduce it and improve your heart health. 

This is especially important for women, says Erin Michos, M.D., associate director of preventive cardiology at the Ciccarone Center for the Prevention of Cardiovascular Disease. Research has shown that the physical effects of stress in women can lead to heart disease and make other existing conditions worse.

For example, women who have higher stress levels may not recover as well as men with similar stress levels after a heart attack. Michos says that women are more likely to have complications after a heart attack, and stress and anxiety may be behind this.

“They might not be doing the things they need to do to relieve stress, like exercising, eating healthfully or going to cardiac rehab. Stress and anxiety can impair their recovery, and could also increase their heart rate and blood pressure,” says Michos.

How Stress Affects Heart Health

Stress isn’t just a state of mind. It actually causes the body to release hormones like adrenaline — the “fight or flight” chemical — which make blood pressure rise and increase heart rate. Another stress hormone is cortisol. High levels of cortisol are linked with increased blood glucose levels and insulin resistance, which can lead to diabetes, heart disease and depression.

The choices some people make to deal with stress can impact health too. Michos notes that stressed people often cope by drinking too much alcohol, avoiding exercise or eating unhealthy foods, all of which can lead to heart disease.

Fortunately, it’s possible to manage stress in healthy ways.

5 Healthy Ways to Manage Stress

1. Be social.

   Seek out time with friends and loved ones for fun and support. “Studies show that social isolation increases the risk of heart disease,” says Michos. Social isolation has been linked with risky behaviors, like physical inactivity and smoking, which can lead to heart disease.

2. Get active.

   Exercise raises endorphins, which boost mood, and keeps your heart healthy through improved fitness. The American Heart Association recommends moderate aerobic exercise 30 minutes per day, five days a week. Michos also recommends increasing activity by using the “20-2-8” rule: For every 20 minutes of sitting, spend eight minutes standing and two walking. She suggests walking at least 10,000 steps per day — keep track of your steps and motivate yourself with a pedometer or activity tracker.

3. Practice mindful eating.

   If you use food as a coping mechanism, pack healthy snacks for when you know you’ll be out, avoid situations where you might make unhealthy choices and plan meals in advance.

4. Look on the bright side.

   Research shows that optimism improves health. For instance, one recent study showed that optimism improved recovery from acute coronary syndrome.

5. Schedule time for yourself.

   “Self-care is important. Women are so busy being caretakers for kids, their spouses and everyone else that they neglect their own health. Make sure to take time out for eating well, exercising and having hobbies that bring you joy,” says Michos.