It has long been believed that stress is an important cause of heart disease, but a new study from Scotland suggests that this assumption may be misleading. Researchers measured stress among 8,000 middle-aged Scottish men and then followed them for more than 20 years to see whether they developed heart disease.

Men who thought they were the most stressed were also most likely to report symptoms of ill health, including angina. However, hospital diagnoses of heart disease, ECG signs of heart disease and death from heart disease were all lower among the men reporting high stress. In fact, death rates from all causes were lower in the stressed men.

The researchers suggest that perhaps some people see themselves as experiencing more symptoms of stress and also more symptoms of illness. This may have led past researchers to wrongly conclude that stress causes heart disease. A limitation of this study is that it analyzed self-reported "stress" rather than using objective measurements.

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Source:  Macleod J, Smith GD, Heslop P, et al. Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men. British Medical Journal, May 25, 2002;324:1247. (Abs.)