If you’ve been slammed at work, eating all the wrong foods at your desk, and trying to figure out where the next window of time for your next gym session is coming from, then you probably didn’t notice that April is “Stress Awareness Month.”

Fortunately, you don’t need to get extra tense for missing the memo, because taking care of your stress levels is something that you can work on all year round. Our hearts are essential for longevity and for reaching peak performance. Short-term energy levels and long-term health outcomes depend on us taking care of our ticker.

So, M&F talked to Dr. Steven Kesten, M.D. F.C.C.P., to find out how we can reduce stress levels and add a few beats.

How does stress relate to heart health?

Clinical studies  show that psychological stress may be important in predicting poor cardiovascular outcomes,” says Kesten, who is also the chief medical officer of CONNEQT Health. “In fact, among people suffering from coronary heart disease, mental stress is more likely to lead to heart attacks, strokes, and other heart problems than physical stress.”

Kesten explains that when we are mentally stressed the “fear center” of the brain, known as the amygdala, triggers a cascade of stress hormones including cortisol and adrenaline, causing our heart to beat more quickly and for blood pressure to increase. While this is a natural and essential “fight or flight” response to danger, it is not healthy for those that are stressed for frequent and prolonged periods of time. It can cause inflammation of the arteries, interfering with clotting and damaging blood vessels. Those physical changes, brought about by mental stress, then lead to the risk of adverse cardiovascular events such as heart attacks and strokes. “Chronic stress can also increase inflammation in the body, which contributes to the buildup of plaque in the arteries,” adds Kesten.

How does stress lead us toward a ‘toxic cycle’?

Stress may also lead to negative lifestyle behaviors as we try to fix our emotions by self-medicating. “Many people self-medicate, and this can worsen health,” says Kesten. “While drugs or alcohol are sometimes mistakenly perceived as providing temporary relief from stress, they tend to exacerbate the overall impact of stress in the long term. Substance use and abuse can lead to addiction, financial problems, relationship issues, and other psychosocial impacts that compound stress. Drugs, smoking, and alcohol can also increase your risk of heart disease, liver disease, lung disease, and cancer. These diseases then increase stress levels further, saddling a person with mental health problems such as anxiety, depression, and addiction. It’s a toxic cycle.”

8 Ways To Manage Your Stress Levels

Dr. Kesten says that there are many ways to reduce stress naturally before picking up a prescription, and has provided some invaluable tips: