Managing Stress for Better Heart Health

Overhaul Your Body

You can improve your overall physical health with proactive, permanent changes. Whether it’s eating better or moving more, the key is to change it up to feel better and achieve a healthier you.

Beth Drossman, WakeMed Healthworks Cardiac Rehabilitation program coordinator, said, “Becoming more active will burn calories, increase metabolism and decrease stress. The more active you become, the better your body will be able to deal with physical stress, which in turn decreases the need to release cortisol.

Cortisol is a steroid hormone that is naturally released in the body in response to stress. As part of the “fight or flight” response, it increases the flow of glucose from the body’s tissues into the bloodstream to provide extra energy to handle a stressful situation.


“If stress is mental or emotional, with no physical component, then we don’t burn the energy provided by the surge of cortisol,” said Drossman. Instead, that energy is stored in the abdomen, stimulating the growth of fat cells.

“Active people also have a lower cortisol response to emotional stress,” said Drossman.

Beyond controlling cortisol levels, there are other benefits to leading an active lifestyle. Active individuals are more likely to see a decrease in their heart rate and blood pressure, higher HDL (good cholesterol) levels and lower triglycerides. In addition to being hearthealthy, an active lifestyle also increases lean body mass and bone density and decreases the chances of developing osteoporosis.

To achieve a healthier, more active lifestyle, the changes don’t need to be drastic. Little additions of movement and exercise can make an impact on health. Good ways to incorporate these changes into your daily life include:

  • Take the stairs instead of the elevator.
  • Park farther away in parking lots.
  • Get up from the desk or TV periodically and walk around.
  • Do home activities like cleaning, gardening or yard work.
  • Walk the dog.

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Drossman suggests purchasing a pedometer and trying to get in at least 10,000 steps (approximately five miles) per day. While this may sound like a daunting aspiration, adding little activities can go a long way to achieving that goal.

“Making one change at a time and building on that works well for most people,” Drossman said. “People often notice a difference after about three weeks of making these changes.”

Mental Overhaul

<p ">Drossman suggests purchasing a pedometer and trying to get in at least 10,000 steps (approximately five miles) per day. While this may sound like a daunting aspiration, adding little activities can go a long way to achieving that goal.

“Making one change at a time and building on that works well for most people,” Drossman said. “People often notice a difference after about three weeks of making these changes.”

Clearing your mind beyond physical clutter is all about keeping the “pie of life” balanced, said Yancey. He identifies six facets of life that are the foundation of a healthy mind:

  • Physical – Making time in your schedule to exercise can help you think more clearly and have more energy.
  • Emotional – Loneliness can be stressful, so forming meaningful relationships with family and friends and developing a sense of community can help lessen stress.
  • Intellectual – Challenge the mind to grow by reading interesting material or losing yourself in a hobby. We can all be adult learners.
  • Sensual – Touch is an important part of life.
  • Spiritual – Being connected to something larger than yourself can help with comfort, support and priorities.
  • Work – It’s not just about pay and benefits. Feeling appreciated and that your contributions are valuable is a big part of a healthy mind. Even in retirement, finding a way to contribute and stay connected to others is fulfilling.

Balancing the pie of life often begins with learning where to draw the line when it comes to commitments. “Try to manage your own time and not let people prevail on you so that you overdo it,” said Dr. Mangano. “Learn to say ‘No’.”

Yancey said most people can tell if their life is in balance or out of balance with some basic questions about their level of fulfillment in those six areas, but making the changes necessary can sometimes be a challenge.

“Sometimes it feels like it would be an additional stressor to rebalance the pie of life,” said Yancey. “It would be stressful, for instance, to implement exercise, but beneficial in the long run. An unbalanced life is stressful, even if it seems easiest because the change can be difficult.”

But Mangano cautions to keep the changes in perspective: “Try not to make too many big life changes all at once, for example: downsizing a home, new job, new spouse and new financial ventures.”

In some cases, people might find it necessary to reach out to a professional for motivation. “For instance, Healthworks has personal trainers who enjoy the challenge of helping persons reach their fitness goals; or if a person consistently feels relationships go south, then a counselor might be helpful in exploring the dynamics involved,” said Yancey. “What we don’t learn from, we tend to duplicate.”

There are many tools that can be used to create mindfulness, like journaling or meditation. But Yancey said friendship is an undervalued facet of mental health. “Friends help us process the stuff of life, like having things in common such as parenting teens and caring for older parents.”


Consult a Cardiologist

Whether it’s cleaning out a junk drawer or coping with emotional stress, what strategies do you suggest for your patients when it comes to de-cluttering stressful areas of their lives?


Charles Mangano, MD | WakeMed Heart & Vascular Physicians

Make a better effort to enjoy life’s simple pleasures. For example, walk in the park, have a picnic, walk or bike on the greenway, go to an outdoor concert, review old photo albums, make a collage, etc.

Wake up with a purpose; try to get more out of each day. Don’t be so hard on yourself! We’re all pilgrims on life’s journey.

Charles Mangano


Jim Locklear, MD | WakeMed Heart & Vascular Physicians

Exercise! Regular exercise is extremely beneficial in relieving stress. Walking at least 150 minutes a week (30 minutes, 5 days a week) lowers blood pressure, lowers cholesterol, and relieves stress.

Jim Locklear, MD


Sahar Amery, MD | WakeMed Heart & Vascular

Take a walk in the park, because nature is very soothing and relaxing. Practice yoga if you can, or just take a moment and breathe deep.

Sahar Amery


Marc Silver, MD | WakeMed Heart & Vascular

I always recommend making lists when I feel overwhelmed. I put check boxes next to each one after prioritizing the list. It’s amazing how life seems more under control when you see yourself making progress in areas of your life that seem overwhelming.

Marc Silver


Kirk Charles, MD | WPP–Vascular and Endovascular Surgery

  1. Prioritize your tasks from “important” to “can wait. Try to address them in that order.
  2. Get help when possible to offload yourself.
  3. It’s okay to say “No.” Don’t take on more than you can handle. Your efficiency will soar and your results will be better.
  4. Don’t worry about what you can’t control.
  5. Try to enjoy what you do.

Kirk Charles, MD

Hands Only CPR

Be prepared for an emergency. Learn to save a life by learning hands only CPR.

  • Identify the warning signs and symptoms of heart attack
  • Know what to do when you or someone else is having a heart attack
  • Learn how to perform CPR
  • Know what to expect when you arrive at the hospital

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