Too much financial stress could lead to a heart attack, according to a new study.

The European Society of Cardiology has found that significant financial stress can increase the odds of having a heart attack by 13 times.

The South Africa-based study matched survey results from 106 heart attack patients with another set of results from 106 patients without cardiac diseases. The former group reported a 96 per cent stress rate with 40 per cent reporting “severe stress levels.”

They were asked to answer questions about depression, anxiety and stress – including stress caused by work and finances. Patients were grouped into four levels: Stress-free (coping financially), mild financial stress (need added support), moderate stress (reported financial distress but had an income), and significantly stressed (struggled to meet basic needs at times and had no income).

"Often patients are counselled about stress after a heart attack but there needs to be more emphasis prior to an event,” Denishan Govender, associate lecturer at University of the Witwatersrand, said in a statement.

“Few doctors ask about stress, depression or anxiety during a general physical and this should become routine practice, like asking about smoking. Just as we provide advice on how to quit smoking, patients need information on how to fight stress."

The report’s findings are being presented at the Annual Congress of the South African Heart Association in Johannesburg.