A new study published in the Journal of the American Medical Association (JAMA) Stress May Link Depression and Anxiety to Cardiovascular Disease by Ruth Rubin MA, confirms what many of us have suspected: chronic stress isn’t just making us miserable—it’s actively damaging our hearts. The research shows stress increases the risk of major adverse cardiovascular events (MACE) by about 50%. Dr. Glenn Levine, a cardiologist at Baylor College of Medicine, calls the relationship “real” and admits “there probably is some causality to it.”
And then comes the part that should alarm us all.
Dr. Levine questions whether cardiologists have the “bandwidth” to discuss mental health and stress with every patient. He’s already pressed for time, he explains, focused on “cardiology studies” and “outside records.” This is “sort of newish type stuff.”
Meanwhile, Dr. Abohashem and his research team hope their findings will “encourage patients to address their chronic stress” through lifestyle changes like better sleep and more exercise.
Do not get me wrong, I’m not here to demonize Dr. Levine—not in the least bit. In fact, is there anyone supporting his stress knowing that the cardiologist may be at heart disease risk just by the overwork of his job? The irony is almost too bitter to swallow: the very doctors studying stress-induced cardiovascular disease are trapped in a system that subjects them to the exact chronic stress they’re researching.
But let me get this straight: We have scientific evidence that chronic stress increases heart attack and stroke risk by 50%.
The cardiologists—the very specialists entrusted with championing our cardiovascular health—openly admit they don’t have time to address it.
And the solution offered is hope that patients will somehow figure it out on their own.
Whose job is it to address a patient’s health?
Is it the patient's responsibility? How are they supposed to find accurate information about managing chronic stress in a sea of wellness gurus, supplements, and conflicting advice? Most patients don't even know stress is a cardiovascular risk factor comparable to other serious health conditions. And I applaud everyone focused on taking these steps—but who's addressing the issues of privilege and access tied to stress management and mental health? Yoga classes, therapy, gym memberships, time off work—these aren't equally available to everyone.
Is it the doctor’s job? They’ve just told us they’re overworked and don’t have bandwidth. Dr. Levine notes that stress may not be “of the magnitude of the more standard risks, like smoking, blood pressure, and diabetes”. But a 50% increased risk is nothing to dismiss. We don’t tell patients, “We don’t have time to discuss your moderately elevated blood pressure.”
Is it hospital administration’s responsibility? Public health’s? Primary Care?
This is the healthcare gap that’s quietly killing people. We have the knowledge. We have the evidence. What we apparently don’t have is a system that can actually deliver that knowledge to the people who need it most—and then support them in making meaningful changes.
When doctors openly admit they lack the time to address known risk factors, we’re not looking at a personal failing. We’re looking at a systems failure. A healthcare model so focused on acute intervention and billable procedures that prevention and holistic care fall through the cracks.
So, what does a functioning system look like? At minimum: integrated behavioral health in primary care settings. Care teams that include health coaches and counselors, not just physicians. Reimbursement models that pay for prevention, not just procedures. Community-level stress reduction programs that don’t require a prescription to access. Medical training that treats psychological factors as foundational, not optional. Education at schools that goes beyond, “this is your body part,” but integrates holistically teaching about health, wellness and prevention (I digress).
But we also have to reckon with who has access to these solutions. Right now, stress management advice often assumes privilege: time for exercise, money for therapy, safe neighborhoods for walking, jobs with flexible schedules. The people experiencing the most chronic stress—often those in poverty, working multiple jobs, living in underserved communities—are the least likely to have access to the very resources recommended to reduce it. Any real solution must be built into the healthcare system itself, not left as optional add-ons that only the privileged can afford.
These aren’t radical ideas. They’re basic requirements for a healthcare system that actually addresses the full spectrum of factors affecting our health.
The answer to “Whose job is it?” shouldn’t be “nobody’s, but we hope patients figure it out.”
If we’re going to take cardiovascular health seriously, we need to take all the risk factors seriously including the ones that can’t be fixed with a prescription pad. That means reimagining how we deliver care, who delivers it, and what we prioritize.
Otherwise, we’re just doing expensive, high-tech damage control while ignoring the fire alarm.
Have you ever had a doctor discuss stress management with you as part of your care? What happened—or didn't happen? Share your experience in the comments.