Imagine a field filled with rocks. Some are massive boulders. Others are small pebbles.
To be as healthy as possible, you need to pick up weight, but you don’t get stronger by putting down boulders just to chase pebbles.
That’s how Braxton Porter, PA-C, a cardiology provider at Intermountain Health, helps patients think about heart health.
“In today’s world, people often focus on the small stuff – the next supplement, diet trend, or health hack,” Porter says. “But the biggest gains still come from the fundamentals.”
Those fundamentals include how well you sleep, how your body handles stress, and how your nervous system supports recovery.
How sleep affects heart health
If there’s one lifestyle factor Porter emphasizes above almost all others, it’s sleep – more specifically, sleep quality.
“Sleep is your body’s primary opportunity to reset, repair, and regulate itself,” he explains. “When sleep quality or duration is impaired, dysfunction can develop across nearly every system in the body, including the heart.”
Research consistently shows that poor sleep and abnormal sleep duration are linked to higher cardiovascular risk. Some studies suggest chronic sleep deprivation may raise the risk of major cardiovascular events by as much as 50%.
At a biological level, good sleep helps:
- Regulate blood pressure
- Improve blood sugar control
- Lower the risk of abnormal heart rhythms
When sleep suffers, those protective systems break down.
Ongoing stress increases cardiovascular risk
Stress triggers real physical changes in the body. In short bursts, stress hormones help you respond, focus, and adapt.
“Many people hear about cortisol and assume it’s always bad,” Porter says. “In reality, a morning cortisol spike is normal and necessary. It’s what helps you wake up and feel alert.”
The problem comes when stress hormones stay elevated for too long.
Chronic stress – driven by factors like ongoing psychological strain, poor sleep quality, unhealthy diet patterns, or untreated mental health concerns – keeps hormones like cortisol and epinephrine switched on. Over time, that constant activation affects how the heart and blood vessels function.
Persistently high stress hormone levels can:
- Raise resting heart rate
- Increase blood pressure
- Disrupt blood sugar control
- Trigger irregular heart rhythms
As this strain continues, it also affects the blood vessels themselves. Chronic stress can make plaque inside the arteries more fragile. When plaque becomes unstable, it’s more likely to crack or rupture – a process that can lead to a heart attack or stroke.
“There’s a strong, well-documented connection between emotional health, anxiety, burnout, and cardiovascular disease,” Porter says. “Over time, these changes have downstream effects that are far from desirable.”
How breathing exercises support heart health
Breathing exercises are often lumped into the “wellness trend” category, but they have real cardiovascular effects.
“Breathing techniques can be a powerful tool for stress management, but they can also directly influence heart rate and blood pressure,” Porter explains. “The American College of Cardiology reports that device-guided breathing techniques can modestly lower blood pressure by up to about 5 mmHg.”
In practical terms, a 5-mmHg drop means the force of blood pushing against artery walls is slightly lower. That small change can ease strain on the heart and blood vessels, especially for people who are close to the high blood pressure range.
What vagal tone means for heart health
The nervous system plays a constant role in how your heart behaves.
Porter explains it this way: “Think of the autonomic nervous system as having a gas pedal and a brake pedal. The “gas pedal” increases heart rate during stress or exercise, while the “brake pedal” slows thing down and promotes rest and digestion. Much of this braking function is controlled by the vagus nerve.”
The vagus nerve is a long nerve that runs from the brain down through the neck and chest, connecting directly to the heart. When it’s activated, it helps slow the heart and shift the body out of stress mode.
People with higher vagal tone – including endurance athletes and some genetically predisposed individuals – tend to have lower resting heart rates because their nervous system is more efficient at calming the heart.
It’s even possible to activate the vagus nerve on purpose using what clinicians call vagal maneuvers. These are simple techniques that briefly increase pressure in the chest and abdomen, which sends a signal through the vagus nerve to slow the heart.
One common example is the Valsalva maneuver — similar to the pressure you create when you strain or bear down. In medical settings, these maneuvers can sometimes slow a racing heart within seconds, without medication.
“When patients come in with very rapid heart rates, we often try vagal maneuvers first,” Porter says. “They’re noninvasive and can slow the heart before we escalate to other treatments.”
The most effective habits for long-term heart health
Once the basics are clear, the question becomes how to focus without getting overwhelmed.
“People often feel pressure to do everything at once,” he says. “But long-term heart health comes from consistency, not intensity.”
The habits with the biggest impact are also the most familiar:
- Move your body regularly. Aim for activity that fits your ability and schedule. Exercise should feel enjoyable, not like a punishment.
- Eat with moderation as the foundation. Unless there’s a medical reason, extreme food rules are hard to sustain and rarely necessary.
- Protect your sleep. Go to bed at a consistent time, build a routine that works for you, and treat sleep as a non-negotiable.
“If you exercise regularly, eat reasonably, and sleep well, you’re taking care of a large portion of your overall health,” Porter says. “That includes your mental health, too.”
Breathing exercises and meditation can support stress management, but they work best when they build on these core habits.
Take a balanced approach to lifelong heart health
Heart health is about balance between mind and body and supporting the systems that help your heart stay resilient over time.
Getting restful sleep, managing stress, and caring for the nervous system strengthen traditional cardiology care. When these systems work together, the heart is better equipped to handle daily demands and long-term challenges alike.
At Intermountain Health, our cardiology teams focus on prevention, evidence-based care, and helping people understand how everyday habits affect their heart. By combining medical expertise with practical guidance, we partner with patients to support heart health not just today, but for years to come.
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