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According to an Ipsos B&A survey of 1,018 participants for the Her Heart Matters campaign, the cost of health checks (25%), stress and lack of time (26%), low motivation (23%), expensive gym memberships (21%), and the high price of healthy foods (18%) all play roles in why many women don't take steps to protect their heart health. But what impact can stress directly have on our heart health over time - and is there any way we can manage this? We got in touch with Dr Malcolm Finlay, consultant cardiologist at Nuffield Health, St Bartholomew's Hospital, to find out… How can stress affect heart health? "Stress can have direct effects on the heart both acutely and chronically," says Finlay. "We know that the body is well able to cope with levels of stress from time to time, but acute levels of mental stress can occasionally be associated with the trigger for abnormal heart rhythms. "In a more chronic setting, stress hormones can drive chronically higher blood pressure, which although may be a minor effect, can lead to long-term damage. Furthermore, stress can drive inflammatory responses of the body by the same pathways that are unregulated in mental stress." He also adds that stress-driving behaviours such as smoking and drinking alcohol to excess may also be adverse to heart health. Is there a link between stress and arrhythmias? "There's substantial direct evidence between how acute mental stress can lead to triggering of arrhythmias," says Finlay. "It seems to both increase the likelihood of extra or ectopic beats, which tend to be the trigger for arrhythmias, but also can change the complex regulation of conduction in the heart. "The evolutionary background for this is to get the heart ready to adapt to extreme exercise scenarios, but in circumstances when this is purely a mental stress rather than extreme exercise, ultimately this may be counterproductive and allow an arrhythmia to onset." Can stress be a trigger for heart attacks or acute cardiac events? "There are well-documented times when acute stress has been ascribed as a trigger event for a heart attack, and this can sometimes be seen in the high risk of cardiac events around surgical procedures," says Finlay. However, he explains that it's hard to say that this is causative. "Usually the acute stress event seems to shift the timing of something that would happen anyway rather than produce a completely new phenomenon," explains the cardiologist. "If, for example, a person has heart disease and is likely to have a heart arrhythmia within the next few weeks or months, an acute stress event may make them more likely to occur around the acute time of that stress event." Furthermore, Finlay highlights that stress is not the sole contributing factor to heart disease or heart attacks. "Controlling mental stress alone won't treat heart disease. Nor is it sufficient to reliably prevent heart disease," clarifies the cardiologist. "All of us will experience stress from time to time and to be able to embrace this and having techniques to manage that will be important rather than to completely try and avoid anything stressful altogether." Here are some stress management techniques that might help negate some of these effects… Think about what may be causing stress in your life "Try and actively remove the chronic things that may cause you stress in life and put the body under excess stress," suggests Finlay. Live a healthy lifestyle "Clearly, doing all the sensible things - not smoking, mitigating alcohol consumption, taking part in regular exercise - will be helpful," says Finlay. Try to reduce your screen time "Although there's much less evidence about the harmful effects of smartphone use, some people can experience these without good management, and an Instagram addiction can seriously affect people's mental health," says Finlay. "Taking control of one's online habits can help." Incorporate exercise into your routine "A really important tip is to build in some type of routine and regular activity," says Finlay. "Regular exercise is going to be extremely helpful as it is well-associated with other beneficial behaviours, such as a good diet and alcohol moderation." Review your priorities "Some other cardiac stress-reducing tips may be to ensure one reviews what is really important to oneself in life rather than being always caught up in the immediate day-to-day," advises Finlay. "I know that's extremely hard for most of us, but it is really important to have one's overall life goals and try and adapt to this."