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*Chronic stress has long been thought of as a risk factor for developing heart disease, but new research reveals for the first time exactly how that connection might work.

A team of medical scientists at Harvard University and the Massachusetts General Hospital in Boston have linked increased activity in the amygdala, a small region of the brain associated with stress, with a greater incidence of cardiac episodes, including heart attack, stroke, angina, peripheral artery disease, or heart failure.

“While the link between stress and heart disease has long been established, the mechanism mediating that risk has not been clearly understood,” said Dr. Ahmed Tawakol, lead author of the study and a cardiologist at Massachusetts General. “This study identifies, for the first time in animal models or humans, the region of the brain that links stress to the risk of heart attack or stroke.”

Tawakol and his team came to their conclusions after following close to 300 adults over age 30 for almost four years. Brain scan images were taken at the start of the study to measure levels of activity in the amygdala. By the end of the study, 22 participants had experienced some type of cardiac episode — and the higher their amygdala levels at the start of the study, the more likely they were to experience heart problems.

The findings suggest that stress could be better monitored and managed by identifying high-risk people through amygdala activity, thus preventing other serious health complications. Heart disease is the number one killer of both men and women in the U.S., and tends to be more prevalent among African-Americans.

“Our results provide a unique insight into how stress may lead to cardiovascular disease,” Tawakol said. “Eventually, chronic stress could be treated as an important risk factor for cardiovascular disease, which is routinely screened for and effectively managed like other major cardiovascular disease risk factors.”

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At the same time, stress is an inevitable part of modern life. Estimates suggest that approximately one million people around the country miss work every day due to work-related stress. But the researchers aren’t suggesting that you eliminate stress, rather, they suggest finding more effective ways to deal with it.

“What matters is how we react to stress,” said Dr. Salman Azhar, director of stroke services at Lenox Hill Hospital in Manhattan. “If we manage stress well with strategies like ‘don’t sweat the small stuff’ and meditation, we might be able to change how this ‘stress ball’ in our brain responds, and actually decrease our chances of having a heart attack.”