When I was diagnosed with coronary artery disease, I did what most of us would do: I went looking for the cause. I'm a clinical nutritionist. I'm lean, I'm active, I've never smoked, I don't have diabetes, and my diet has been genuinely good for years. So what on earth was driving plaque into my arteries?
The honest answer took me a while to accept, and it's the reason I wanted to write this. The factor I had been quietly ignoring for decades was stress.
Why I stopped looking for a single cause
We're wired to want one culprit. One food, one habit, one gene we can point at and say, there it is. I asked that question of myself for months, and what I kept coming back to is that it doesn't work that way. Heart disease is multifactorial.
Coronary artery disease is a build-up of plaque beneath the endothelium — the delicate inner lining of your arteries. That build-up narrows the vessel and restricts blood flow. In my case, both into and out of the heart. The recognised contributors are a long list: physical inactivity, excess weight, smoking, poor diet, diabetes and insulin resistance, high cholesterol, and genetics.
Going down that list honestly, three applied to me. I have a family history of high cholesterol. I have a family history of heart disease, which suggests a genetic predisposition even though I haven't had genetic testing. And I have had decades of chronic stress. I've come to think of it this way: genetics loads the gun, but it's your environment that pulls the trigger.
The link between chronic stress and heart health
I came across a piece from Yale Medicine making the case that psychological stress may be one of the most significant drivers behind the rates of heart disease we're now seeing. It's a view that's gathering attention rather than a settled conclusion, and I'd encourage you to hold it as one lens rather than the final word. But the logic landed for me, particularly this part: smoking rates have been falling for decades while heart disease has not followed them down. Something else is in play.
The proposed mechanism is inflammation. Prolonged stress keeps you in a low-grade inflammatory state, and that inflammation appears to damage the protective layer sitting over your artery walls. Once that protective layer is compromised, cholesterol and fats can pass underneath it, where plaque accumulates and eventually hardens.
What matters here is the word chronic. I'm not talking about a stressful morning. Coronary artery disease develops over decades, and so does the kind of stress that contributes to it. Mine didn't arrive overnight. It accumulated quietly over a very long time while I told myself I was coping.
Your body can't tell the difference
Here's what I find genuinely useful to understand. Your stress response doesn't assess how serious a threat actually is. It responds to your perception that something has more downside than upside.
Historically, that calculation was about survival, so your physiology treats a perceived negative as a threat to your life. Today the threat isn't a predator. It's your phone battery dropping to four per cent before a meeting. Your body doesn't know the difference. It releases adrenaline and noradrenaline, lifts your heart rate, and pushes oxygen out to your muscles so you can fight, flee or freeze.
And it genuinely doesn't matter which of those three is your pattern. Some people charge straight at the stressor. Some avoid it entirely. Some go completely still. Internally, the response is the same: your body is preparing to protect your life. That's a brilliant system for a short burst. It was never designed to run continuously for twenty years.
What recovery actually looks like
This is where I had to change my thinking, because for a long time my answer to stress was simply to push harder.
Often you can't remove the stressor. If your workload is relentless and genuinely isn't changing this quarter, the question shifts from how do I eliminate this to how do I help my body recover alongside it. That's not a soft question. It's the whole question.
For me that means genuine restorative practice, not just the absence of work. Mindfulness. Protected time doing something I actually enjoy. Sleep I don't negotiate with. Anything that brings my heart rate down and lets the system stand down from alert. The specific practice matters far less than doing it consistently. What you want to avoid is the pattern I ran for years: constant fighting, not sleeping properly, never truly recovering.
There's an acute side to this too. Severe, sudden stress can cause a soft plaque to rupture, and that's when a clot can form — the mechanism behind many heart attacks and strokes. So managing both the chronic background load and your response to acute spikes genuinely matters.
Key takeaways
- Stop hunting for one cause. Go through the recognised contributors honestly and work on the ones that actually apply to you.
- Treat chronic stress as a physical health factor, not a personality trait or an unavoidable feature of modern life.
- Your stress response fires on perception, not on real danger — so noticing what you're framing as a threat is useful work.
- When you can't remove the stressor, build in recovery instead: restorative practice, protected downtime, non-negotiable sleep.
- Consistency beats intensity. A small daily wind-down does more than an occasional week off.
- If heart disease runs in your family, talk to your GP about screening rather than waiting for symptoms.
Where this fits in the bigger picture
I've spent my career helping people with nutrition, and I stand by every bit of it. But my own diagnosis taught me something I now bring to every client conversation: you cannot eat your way around an unmanaged nervous system. Diet, movement, sleep, light, stress and purpose all sit in the same system, and if you leave one of them neglected for long enough, it will eventually speak up.
That's the holistic approach we take at me&my wellness. Not a protocol, but a proper look at the whole picture — including the parts you've been quietly tolerating. If my own story is any guide, the factor you're most inclined to dismiss is often the one worth examining first.
This article is general information and isn't a substitute for personal medical advice. Please discuss any symptoms, concerns or changes to your routine with your doctor, and don't delay seeking care because of something you've read here.
Want to go deeper on this? Book a free 30-minute discovery call with Anthony at meandmywellness.com.au