Today, let's talk about a woman who pays close attention to her health. Let's say she's been doing everything right. For years she's exercised regularly, kept her weight in check and followed a balanced diet that includes plenty of fresh whole foods and a minimum of processed foods. And yet, in spite of these healthy ways she may still be at risk of developing type 2 diabetes and heart disease.

A new study from the British Medical Journal reveals why.

Long term stress is linked to metabolic syndrome
Why does stress increase heart disease risk?

UK researchers at the University College London (UCL) say they've found evidence that metabolic syndrome may provide the primary link between stress and heart disease.

Metabolic syndrome (sometimes called metabolic syndrome X, or MSX) is a combination of symptoms that creates a high risk of type 2 diabetes and heart disease. The core symptoms include high blood pressure, excessive abdominal fat, high triglyceride level, high C-reactive protein level, low HDL cholesterol level and insulin resistance. The presence of just three or more of these symptoms is enough to diagnose MSX. And although it's not a symptom, cigarette smoking is also considered part of the MSX package.

UCL researchers designed a study to evaluate a possible association between stress in the workplace and MSX. Using data collected on more than 10,000 middle-aged, male and female civil servants in London, the UCL team compared stress to MSX markers. For each subject, stress was measured four times over a period of about 14 years using the iso-strain model; an assessment of occupational stress in which the demands of a job are compared to worksite social support.

The most surprising result: Prolonged work stress was linked to high MSX risk, independent of other risk factors. Subjects with chronic work stress were found to be twice as likely to develop MSX compared to low-stress workers. The UCL team concluded that 'psychosocial stressors from everyday life' are linked to heart disease through MSX.

Lifestyle changes can help combat metabolic syndrome
Commenting on the UCL study, professor Peter Weissberg, medical director of the British Heart Foundation, told Reuters Health that the good news concerning metabolic syndrome is that many of the symptoms can be addressed with lifestyle changes: The overweight can lose weight, the sedentary can start exercising, and smokers can stop smoking.

Now it seems that reducing stress can be added to that list, although (like the other factors) it's much easier said than done. Fortunately, some of the healthy habits that address MSX symptoms can also relieve stress. Getting regular exercise and following a balanced, nutritious diet may be very helpful in reducing stress, especially if you're getting the right amount of sleep.

Stress overload may also be lessened with an increased consumption of certain nutrients, such as vitamin C and beta-carotene.

Gold standard tests often fail to find heart disease in women
A study being published on 7 February in the Journal of the American College of Cardiology, found that heart disease is often underdiagnosed in women.

Research from the US National Institutes of Health (NIH), found that for 60 percent of woman the first sign of heart disease is a heart attack.

According to the research, the problem is that the gold standard tests miss the signs of heart disease in women. Scientists believe that this is because blockages in women build up evenly on the artery walls, narrowing the passage. In men, however, the blockages tend to accumulate in visible clumps.

Dr. C. Noel Bairey Merz, medical director of the Preventive and Rehabilitative Cardiac Centre at Cedars-Sinai Medical Centre, commented, We often did not detect it on coronary angiograms, which is basically our gold standard for diagnosing blockages of the arteries.

To accurately detect heart disease, women may require different tests to see how smaller coronary arteries respond to stress. They include cardiac MRIs, stress echocardiograms and micro heart catheterisation.

Women, the next time you go to your doctor, talk to them about running these tests to help determine if you are developing heart disease.