Stress increases the risk of heart attack by pushing people toward bad habits. A British study published in the Journal of the American College of Cardiology suggests that people with psychological stress had a 50% increased risk of a cardiovascular disease event over the follow–up period.

The reasons were higher smoking rates and low exercise levels of individuals who were stressed.

In the study over a 7-year follow–up period, incidence of cardiovascular events –– heart attacks, stroke, bypass surgery and the like –– was 50% higher among the people with a high level of depression and anxiety when compared to happier people. Smoking and lack of physical activity explained about 63% of the increase, with smoking alone responsible for 41%.

Alcohol intake explained less than 2% of the increase, with high blood pressure assigned 13% of the blame. All such patients should be treated with combined physiological approaches with intensive lifestyle changes to reduce modifiable risk.