Adults who struggle to pay their bills are 13 times more likely to have a heart attack, new research suggests.
As The Daily Mail reports, South African scientists also discovered the risk is increased six-fold in those with stressful jobs.
The new claim echoes research published in February in The Lancet that stress is as likely as smoking and high blood pressure to cause heart and circulatory diseases.
Doctors are now urging for updated guidelines to ask heart attack patients about their level of stress at work and home, in a bid to achieve earlier diagnosis and quicker intervention.
The findings suggest that all patients should urgently be offered information on how to combat stress.
Doctors have been urged to identify possible barriers to lifestyle change or adherence to medication, so they can maximise the effectiveness of their plan to slash their patients' risk of repeat attacks.
University of the Witwatersrand researchers used data from 106 patients who suffered heart attacks and were admitted to a hospital in Johannesburg.
Lead researcher, Dr Denishan Govender, revealed his team's findings at the Annual Congress of the South African Heart Association in Johannesburg.
'Often patients are counselled about stress after a heart attack but there really needs to be more emphasis prior to an event,' he said.
'Few doctors ask about stress, depression or anxiety during a general physical. This should become routine practice, like asking about smoking.
Dr Govender added: 'Just as we provide advice on how to quit smoking, patients need information on how to fight stress.'
For the study, each participant was asked to grade their levels of financial stress.
The answers ranged from no stress, mild, moderate or significant - depending on their income and outgoings.
Researchers then delved into the data from the Interheart Study to determine if there was a link between the two.
The results found a 13-fold increase in the likelihood of a heart attack arose in those with 'significant' financial pressures.
As well as pressure from paying bills, the report revealed depressed adults were at triple the risk of suffering a heart attack.
Self-reported stress levels were common, with 96 per cent of heart attack patients reporting any level of stress.
Some 40 per cent reported severe stress levels.
Commenting on the new study, Dr David Jankelow, chairman of the SA Heart 2017 Congress, suggested possible changes to medical guidelines for heart attacks.
He said: 'We know that the depressed cardiac patient is at greater risk.
'We as clinicians need to identify them much earlier, so that they can be referred for appropriate intervention.
'Cardiac rehabilitation together with counselling and reassurance will play an important role as well.'