Sept. 20, 2007 -- Here's a health fact most of us understand better than our doctors do: Emotional stress really can harm our hearts.

Intense grief, acute anger, and sudden fear can have direct -- sometimes fatal -- effects on the human heart. And long-term emotional stress shortens lives by increasing the risk of heart disease, notes Daniel J. Brotman, MD, director of the hospitalist program at Johns Hopkins Hospital, Baltimore.

"What is intuitive to people is not necessarily intuitive to physicians," Brotman tells WebMD. "Emotional stress, conceptually, is the same thing for cardiovascular risk as physical stress. But a lot of doctors blow that off, because they think emotional stress is a psychological problem, not a physical problem."

To overcome this false impression, Brotman and colleagues reviewed recent studies looking at the short- and long-term effects of emotional stress on the heart. Their resulting report, "The Cardiovascular Toll of Stress," appears in the Sept. 22 issue of The Lancet.

"In the hospital, I see people under all sorts of stress all the time -- and I see what happens to bodies under stress," Brotman says. "Our study illustrates how important the body's stress responses are in precipitating cardiovascular effects."