Levin, 56, of San Diego, wasn't overweight and didn't have high blood pressure or high cholesterol. But she'd recently started taking care of her mother, who had Alzheimer's disease.
"While people know stress plays a role in how they feel physically, they're often unaware that it is a risk factor for heart disease," says Suzanne Steinbaum, MD, an attending cardiologist at Lenox Hill Hospital in New York City.
Stress creates inflammation
Several studies have linked stress, job strain, and general demoralization to a greater risk for heart disease, though the relationship is less causal than other lifestyle factors, like smoking.
Stress triggers an increase of cortisol, a "stress hormone," which can raise blood-sugar levels and blood pressure. The overproduction of cortisol can lead to a constant state of chemical arousal, which can eventually cause a heart attack.
One study of Belgian workers found that those who reported feeling they had little control of their work life had increased levels of markers of inflammation such as C-reactive protein and fibrinogen, which are linked to heart disease.