If you’re among those who thrive on constant challenges, deadlines and stress, you need to know what it’s doing to your heart.

Stress long been considered a risk factor in heart disease and stroke, but a new study may tell us exactly why. Researchers have found that heightened activity in the amygdala — a region of the brain involved in stress — may be the culprit, according to a study published in The Lancet.

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Animal studies had previously identified a link between stress and higher activity in the bone marrow and arteries, but the response in humans was largely unknown.

Other research has also shown that the amygdala is more active in people with post-traumatic stress disorder (PTSD), anxiety and depression, but before this study no research had identified the region of the brain that links stress to the risk of heart attack and stroke.

The study, partially funded by the National Heart, Lung, and Blood Institute, was conducted by scientists from Massachusetts General Hospital and Harvard Medical School, Cornell Medical College, Icahn School of Medicine at Mount Sinai and Tufts University.

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Researchers gave 293 patients a combined PET/CT scan to record their brain, bone marrow and spleen activity and any inflammation in their arteries. Patients were then tracked for an average of 3.7 years to see if they developed cardiovascular disease.

Twenty-two patients had cardiovascular events during that time, including heart attack, angina, heart failure, stroke and peripheral arterial disease.

Those with higher amygdala activity had a greater risk of increased bone marrow activity, inflammation in the arteries, subsequent cardiovascular disease and developed problems sooner than those with lower activity.

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The authors believe the amygdala signals to the bone marrow to produce extra white blood cells during times of high stress, which in turn act on the arteries — causing them to develop plaques and become inflamed, which can cause heart attack and stroke.

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“In the past decade, more and more individuals experience psychosocial stress on a daily basis,” Dr. Ilze Bot, at the Leiden Academic Centre for Drug Research, Leiden University, The Netherlands, wrote in an article linked to the study. “Heavy workloads, job insecurity, or living in poverty are circumstances that can result in chronically increased stress, which in turn can lead to chronic psychological disorders such as depression.”

While more research is needed to confirm the mechanism, she concludes: “These clinical data establish a connection between stress and cardiovascular disease, thus identifying chronic stress as a true risk factor for acute cardiovascular syndromes.”