The science of stress

Stress shown by illustration of broken link from brain to heart

New research suggests that brain activity could predict stress-induced cardiovascular disease – and that some of us are more susceptible to it than others. We look at how controlling work-related stress delivers benefits far beyond mental wellbeing

Even though stress is increasingly recognised for the serious mental health issue that it is, it is often underrepresented as a significant risk to physical health. Indeed, leading experts such as the British Heart Foundation do not consider stress to be a direct risk factor for cardiovascular disease. Even though the link between stress and heart disease has been known for over a decade, the mechanism by which this link occurs has long puzzled scientists.

But a recent study in the medical journal The Lancet suggests the link between stress and cardiovascular disease could lie in the brain. The findings contend that some people could be more at risk of cardiovascular diseases such as stroke and heart attack than others.

The study monitored brain activity, bone marrow activity and arterial inflammation in 293 individuals with a median age of 55; over the course of the four year study, 22 people suffered a cardiovascular disease event. It was found that those with higher levels of activity in an area of the brain called the amygdala were more likely to develop cardiovascular disease down the line.

The amygdala – a pair of almond-shaped neurons located deep within the brain’s medial temporal lobe – has been linked in the past to the processing of primal emotions like fear and stress.

Researchers suggest that an overactive amygdala might signal to the bone marrow to produce extra white blood cells, prompting the arteries to develop plaque and become inflamed, which can lead to cardiovascular diseases including heart attack, stroke, angina and heart failure and peripheral arterial disease.

Stress and the workplace

While the study doesn’t explicitly prove that amygdala activity or stress cause cardiovascular disease, the findings nevertheless suggest that some of us may be more at risk of cardiovascular disease as a result of stress than others. “This raises the possibility that reducing stress could produce benefits that extend beyond an improved sense of psychological wellbeing,” said Dr Ahmed Tawakol, lead author of the study and a cardiologist at Massachusetts General Hospital.

According to new research by Bupa, over half of the UK workforce have felt unwell due to a poor work-life balance. In addition to physical sickness, work stress has kept 51 per cent of employees awake at night. Presenting at an important meeting or managing a project are considered more stressful than buying a house or getting married, while two fifths of the workforce state stress is “ruining their life”.

A string of recent high-profile stress cases complement these findings – in 2011 António Horta-Osório, chief executive of Lloyds Banking Group, took a temporary leave of absence after only six months on the job, as did Ton Büchner, chief executive of Dulux paint maker AkzoNobel in 2012, both citing “fatigue”. In September 2015, Harald Krüger, chief executive of BMW, collapsed onstage at the Frankfurt motor show, sparking rumours that he was suffering from burnout, while Tadashi Ishii, the head of Japan’s biggest advertising agency, Dentsu, resigned in 2016 after an employee committed suicide in a case of what is known as ‘karoshi’ – death from overwork.

“Over the past decade, an increasing amount of individuals are experiencing psychosocial stress on a daily basis,” says Dr Ilze Bot of the Leiden Academic Centre for Drug Research, Leiden University. “Heavy workloads, job insecurity, or living in poverty are circumstances that can result in chronically increased stress, which can lead to chronic psychological disorders, such as depression. These clinical data identify chronic stress as a true risk factor for acute cardiovascular syndromes.”

So, how do we keep stress levels at bay, particularly in the work environment? Some coping mechanisms can be more detrimental than others – smoking, drinking too much alcohol and overeating can further increase our risk of heart disease. But failing to take control of the problem will only allow it to worsen.

It’s important that everyone across the organisation – from employees, to line managers, to non-execs and the C-suite – understands stress and its impact on mental and physical health. The Health and Safety Executive has identified six key factors in work-related stress, including the demands of your job, the control you have over your work, the support you receive from managers and colleagues, and management of organisational change.

But stress can manifest itself in many ways, and these may not be immediately apparent in yourself or your employees. Symptoms include problems sleeping, excessive tiredness, feeling sad, irritable and tearful, feeling the need to drink alcohol and losing one’s temper.

With 64 per cent of the workforce believing they would be significantly more productive at work if they were less stressed, and in light of the discovery that it could be directly linked to serious health problems, fighting stress protects more than just mental wellbeing.

5 steps to reducing stress

1. Inhale and exhale

Take a few deep breaths – this will calm your mind and give you some perspective on your situation

2. Take a break

Have a proper lunch break of at least 30 minutes away from your desk, so you can switch off from work

3. Say something

Talk through your problems with colleagues, friends and family. Having a support network is vital to managing stress

4. Exercise!

Being active enables you to let off steam and clear your head. Physical activity causes chemical changes in the brain, which can positively affect mood

5. Eat and drink smart

Eating nourishing foods and avoiding damaging habits like smoking and drinking excessive alcohol will boost your energy and keep your gut healthy

Interested in finding out more on mental health?

The IoD is committed to raising awareness of mental health issues in the workplace, with a particular focus on opening up the conversation for small-and medium-sized businesses. We have created a hub packed full of helpful advice, best practice and useful resources, as well as shared experiences from business leaders.

Visit our mental health in the workplace hub here and get involved in the conversation on Twitter #IoDMH

IoD members can access factsheets and other resources on mental health and stress management in the workplace via the IAS at

Watch the TED-Ed video on how stress affects the body

About author

Hannah Gresty

Hannah Gresty

Until she left the magazine in August 2019, Hannah Gresty was the assistant editor of Director. She previously worked on a local news website and at a fashion PR company before joining the Director team as editorial assistant in 2016.

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