Fibromyalgia is best known for causing widespread pain, fatigue, sleep problems, tenderness, and difficulty concentrating, but its effects may extend beyond the muscles and joints.
Researchers have increasingly studied how fibromyalgia interacts with the nervous system, blood vessels, physical activity, sleep, metabolism, and cardiovascular function.
This has raised an important question: How does fibromyalgia affect your heart health? Fibromyalgia itself is not considered a traditional heart disease, and having fibromyalgia does not automatically mean that someone will develop cardiovascular disease.
Fibromyalgia may influence heart health through chronic pain, stress, poor sleep, reduced activity, and changes in autonomic nervous system function.
However, research suggests that people living with fibromyalgia and other forms of chronic widespread pain may experience changes in heart-rate regulation, autonomic nervous system activity, physical conditioning, blood pressure, sleep quality, and metabolic health that could influence cardiovascular well-being over time.
Understanding these connections can help people with fibromyalgia recognize symptoms that deserve medical attention while also taking practical steps to support both their pain management and long-term heart health.
What Is Fibromyalgia?
Fibromyalgia is a chronic condition characterized primarily by widespread musculoskeletal pain. People may also experience significant fatigue, disrupted or non-refreshing sleep, headaches, stiffness, cognitive difficulties often described as “fibro fog,” mood changes, digestive complaints, and increased sensitivity to touch, temperature, light, or other stimuli.
Rather than being simply a disorder of sore muscles, fibromyalgia is thought to involve alterations in the way the brain and nervous system process pain and other sensory signals.
Symptoms can vary considerably from one person to another. Some people remain physically active and experience relatively manageable symptoms, while others have severe pain and fatigue that interfere with exercise, sleep, work, and daily activities.
That difference matters for cardiovascular health because heart risk depends on many interacting factors, including activity level, weight, blood pressure, cholesterol, diabetes, smoking, sleep, age, family history, and overall health.
Does Fibromyalgia Directly Damage the Heart?
Current evidence does not establish fibromyalgia as a condition that directly damages heart muscle in the way that coronary artery disease, myocarditis, or heart failure can.
Instead, researchers are studying several indirect and physiological connections between fibromyalgia and cardiovascular health.
These include:
- Changes in autonomic nervous system activity
- Lower heart-rate variability in some patients
- Faster heart rate or palpitations
- Orthostatic intolerance and dizziness
- Reduced physical activity and cardiovascular conditioning
- Sleep disturbances
- Metabolic risk factors
- Chronic stress responses
- Possible alterations in inflammatory and neuroendocrine signaling
Population studies have also reported associations between chronic widespread pain or fibromyalgia and cardiovascular disease. However, observational studies cannot prove that fibromyalgia itself directly causes these conditions. Other health and lifestyle factors may contribute to part of the association.
1. Fibromyalgia May Affect the Autonomic Nervous System
One of the most extensively studied links between fibromyalgia and heart health involves the autonomic nervous system.
The autonomic nervous system automatically regulates many functions that you normally do not have to think about, including:
- Heart rate
- Blood pressure
- Breathing
- Digestion
- Body temperature
- Blood-vessel constriction
- Stress responses
It has two major branches that are commonly described as the sympathetic and parasympathetic nervous systems.
The sympathetic system helps prepare the body for activity or stress. The parasympathetic system plays a larger role in rest, recovery, and energy conservation.
Several studies have found evidence of altered autonomic regulation in people with fibromyalgia. A systematic review examining heart-rate variability found that many studies reported lower heart-rate variability and signs of increased sympathetic activity compared with healthy controls.
This does not mean every person with fibromyalgia has cardiovascular autonomic dysfunction. It does suggest that nervous-system regulation of the cardiovascular system may be different in some people with the condition.
2. Fibromyalgia and Heart-Rate Variability
Heart-rate variability, commonly abbreviated HRV, describes the small variations in time between individual heartbeats.
A healthy heart does not beat at perfectly equal intervals. Instead, the timing changes slightly depending on breathing, activity, stress, sleep, and nervous-system signals.
Higher HRV is generally associated with greater autonomic flexibility, although interpretation depends heavily on factors such as age, fitness, medications, recording method, and health status.
Research involving fibromyalgia has frequently reported reduced HRV compared with people without fibromyalgia. Meta-analyses involving chronic pain and functional syndromes have also identified reductions in HRV measures associated with parasympathetic activity.
However, HRV should not be treated as a stand-alone diagnostic test for fibromyalgia or heart disease. Consumer smartwatches and fitness trackers can estimate HRV, but a low reading does not automatically mean that someone has a cardiovascular problem.
The findings are more useful for researchers trying to understand how chronic pain and the nervous system may interact.
3. Fibromyalgia May Cause Palpitations or a Racing-Heart Sensation
Some people with fibromyalgia describe feeling that their heart is:
- Racing
- Pounding
- Fluttering
- Skipping beats
- Beating harder than expected
There are several possible explanations.
Pain itself can activate stress responses and increase sympathetic nervous system activity. Anxiety, poor sleep, dehydration, caffeine, certain medications, anemia, thyroid disorders, arrhythmias, and cardiovascular conditions can also cause similar symptoms.
Fibromyalgia-related autonomic disturbances have been associated in research with symptoms such as tachycardia and postural intolerance.
But palpitations should not automatically be blamed on fibromyalgia.
New, persistent, severe, or unexplained palpitations deserve evaluation, particularly when accompanied by fainting, severe dizziness, shortness of breath, chest pressure, or exercise intolerance.
4. Standing Up May Affect Heart Rate and Blood Pressure
Another connection between fibromyalgia and cardiovascular regulation involves orthostatic intolerance.
Orthostatic intolerance refers to symptoms that develop or become worse while standing upright. These may include:
- Lightheadedness
- Rapid heartbeat
- Weakness
- Blurred vision
- Fatigue
- Feeling faint
- Brain fog
- Exercise intolerance
Older and emerging research has found autonomic abnormalities and orthostatic symptoms in subsets of people with fibromyalgia.
One specific autonomic condition is postural orthostatic tachycardia syndrome, or POTS, which involves an excessive increase in heart rate after moving upright along with chronic orthostatic symptoms.
Fibromyalgia and POTS can coexist, but they are separate conditions. Having dizziness or a fast heartbeat with fibromyalgia does not automatically mean someone has POTS.
Anyone experiencing repeated fainting, significant heart-rate increases while standing, or persistent dizziness should discuss those symptoms with a healthcare professional rather than attempting to diagnose the cause independently.
5. Chronic Pain Can Put the Body Under Repeated Stress
Pain is not simply an uncomfortable sensation. It also activates physiological systems throughout the body.
During episodes of significant pain, the body may release stress-related signals that influence:
- Heart rate
- Blood pressure
- Muscle tension
- Breathing
- Sleep
- Hormonal activity
Short-term activation of these systems is normal.
The concern in chronic pain conditions is that the body may experience repeated or prolonged stress signaling over months or years.
A 2025 systematic review and meta-analysis examining chronic pain found an association between chronic pain and hypertension, including an association in people with chronic widespread pain. The researchers also emphasized considerable variability between studies, meaning the relationship remains complex.
For people with fibromyalgia, this reinforces the value of monitoring traditional cardiovascular factors instead of concentrating exclusively on pain symptoms.
6. Fibromyalgia Can Make Exercise More Difficult
Regular physical activity is one of the most important tools available for supporting cardiovascular health. Unfortunately, fibromyalgia can make exercise unusually challenging.
Pain may increase during or after activity. Fatigue can make even ordinary daily movement feel demanding. Poor sleep may reduce energy, while fear of triggering a flare can encourage people to avoid exercise altogether.
Over time, reduced activity can contribute to physical deconditioning. Research reviews have reported that people with fibromyalgia often demonstrate more sedentary behavior, lower activity levels, and reduced physical conditioning compared with healthy individuals.
Physical inactivity matters for the heart because regular movement helps support:
- Cardiovascular fitness
- Healthy blood pressure
- Insulin sensitivity
- Weight management
- Blood lipid levels
- Circulation
- Muscle strength
- Emotional well-being
The goal, however, should not be to start intense workouts suddenly.
7. The Right Kind of Exercise May Help Both Fibromyalgia and Heart Health
For many people with fibromyalgia, gradual and individually appropriate exercise can be beneficial.
Mayo Clinic recommends regular exercise as part of fibromyalgia management, noting that starting slowly and increasing activity over time may help relieve symptoms. Potential activities include walking, swimming, cycling, and water aerobics.
A practical approach might begin with very short periods of comfortable activity and gradually increase duration based on tolerance.
Options can include:
- Gentle walking
- Stationary cycling
- Swimming
- Water exercise
- Light resistance training
- Stretching
- Mobility exercises
The ideal program varies substantially between individuals.
Someone with severe exercise intolerance, unexplained breathlessness, fainting, significant palpitations, or known cardiovascular disease should obtain personalized medical guidance before increasing exercise intensity.
The goal is sustainable movement, not pushing through extreme symptoms.
8. Poor Sleep Creates Another Heart-Health Connection
Sleep problems are extremely common in fibromyalgia. A person may spend enough hours in bed but still wake feeling exhausted because sleep is fragmented or nonrestorative.
That can influence heart health indirectly. The American Heart Association notes that insufficient and disrupted sleep are connected with cardiovascular risk factors such as high blood pressure, obesity, diabetes, inflammation, and unfavorable lifestyle patterns.
For someone living with fibromyalgia, improving sleep may therefore have benefits beyond reducing fatigue.
Useful sleep habits include maintaining consistent sleep and wake times, creating a quiet, dark sleeping environment, limiting late caffeine intake, staying physically active when possible, and discussing persistent insomnia or suspected sleep disorders with a healthcare professional.
Identifying sleep apnea is particularly important because untreated sleep apnea has significant cardiovascular consequences.
9. Fibromyalgia, Obesity, and Metabolic Health
Weight is another area where fibromyalgia symptoms and cardiovascular health can overlap.
A systematic review and meta-analysis of fibromyalgia and obesity reported a substantial prevalence of obesity among people with fibromyalgia and found associations between obesity and several measures of symptom severity and physical functioning.
More recent research has also examined the overlap between fibromyalgia and metabolic syndrome.
Metabolic syndrome refers to a combination of cardiovascular and metabolic risk factors that can include:
- Abdominal obesity
- Elevated blood pressure
- Abnormal cholesterol or triglycerides
- Impaired glucose regulation
These factors are important because they contribute to cardiovascular disease risk independently of fibromyalgia.
Weight management can be especially difficult when pain, fatigue, sleep problems, and reduced activity occur together.
Rather than focusing only on the number on the scale, people with fibromyalgia may benefit from concentrating on sustainable habits: nutrient-dense foods, adequate protein, fiber-rich foods, appropriate portions, regular movement, good sleep, and routine metabolic screening.
10. Is Fibromyalgia Associated With Coronary Heart Disease?
Some epidemiological studies suggest an association. A large Taiwanese population-based cohort study followed more than 60,000 patients identified with fibromyalgia and compared them with matched controls.
Researchers reported a higher rate of coronary heart disease among the fibromyalgia group even after statistical adjustments for several cardiovascular and psychological factors.
More recently, a 2026 systematic review and meta-analysis examined chronic widespread pain, a category closely related to fibromyalgia but not identical to it.
After greater statistical adjustment, chronic widespread pain remained associated with a higher risk of incident atherosclerotic cardiovascular disease. However, evidence regarding cardiovascular mortality became less convincing, and researchers noted substantial heterogeneity among studies.
These results are important, but they do not prove that fibromyalgia directly causes blocked arteries. Possible contributors include physical inactivity, metabolic factors, sleep disorders, chronic stress, autonomic abnormalities, medications, smoking, socioeconomic factors, and other health conditions.
The most useful takeaway, then, is not fear—it is prevention and appropriate cardiovascular screening.
11. Does Fibromyalgia Cause Inflammation Around the Heart?
This is a common misunderstanding. Fibromyalgia is not the same thing as an inflammatory heart condition such as myocarditis or pericarditis.
Research continues to investigate whether people with fibromyalgia show differences in certain inflammatory, immune, neuroendocrine, or oxidative-stress biomarkers.
A 2026 systematic review and meta-analysis reported alterations in several inflammatory biomarkers in fibromyalgia populations, but these findings do not mean fibromyalgia should simply be classified as a systemic inflammatory disease.
More importantly, such research cannot be used to conclude that fibromyalgia is causing inflammation in the heart.
A person experiencing symptoms suggestive of myocarditis, pericarditis, or another cardiovascular condition needs appropriate medical evaluation.
12. Fibromyalgia Chest Pain Is Not Always Heart Pain
People with fibromyalgia can experience pain across many parts of the body, including the chest wall, ribs, shoulders, upper back, and muscles surrounding the chest.
Musculoskeletal chest pain originates from muscles, joints, bones, connective tissues, or cartilage rather than from the heart itself.
Costochondritis, for example, causes pain involving the cartilage connecting the ribs to the breastbone. The difficulty is that chest-wall pain can be hard to distinguish from heart-related chest pain based solely on how it feels. That is why new chest pain should never automatically be dismissed as fibromyalgia.
When Is Chest Pain an Emergency?
Seek emergency medical attention for chest pain or pressure that is severe, new, unexplained, or accompanied by symptoms such as:
- Shortness of breath
- Cold sweating
- Fainting
- Severe weakness
- Nausea
- Pain spreading toward the arm, shoulder, back, neck, or jaw
- Sudden unusual pressure or squeezing in the chest
People who have experienced fibromyalgia chest pain before should still take new or significantly different symptoms seriously.
Fibromyalgia and cardiovascular disease can exist at the same time.
13. Stress and Anxiety Can Influence Cardiovascular Symptoms
Living with chronic pain can be stressful.
A person may worry about when the next flare will occur, struggle with sleep, reduce social activities, miss work, or feel uncertain about symptoms. Stress and anxiety can also influence physical sensations.
Adrenaline and other stress responses may increase heart rate, breathing rate, sweating, and awareness of the heartbeat. In some people, this can make palpitations or chest discomfort feel especially noticeable.
However, describing symptoms as anxiety-related should come after reasonable medical evaluation when cardiovascular symptoms are present, not as an automatic explanation.
Physical symptoms deserve to be taken seriously even when stress contributes to them.
14. Medications May Also Affect Heart Rate or Blood Pressure
Many people with fibromyalgia take medications for pain, sleep, mood symptoms, headaches, or additional medical conditions.
Some medicines can affect:
- Heart rate
- Blood pressure
- Fluid balance
- Alertness
- Weight
- Exercise tolerance
For that reason, anyone noticing new palpitations, dizziness, swelling, unusual fatigue, or blood-pressure changes after starting or changing medication should speak with the prescribing clinician.
Do not stop prescribed medication suddenly unless specifically instructed to do so.
Medication review is especially valuable when you are taking several drugs or supplements at the same time.
How to Protect Your Heart When You Have Fibromyalgia
Fibromyalgia does not mean poor heart health is inevitable.
Many of the most effective cardiovascular strategies are the same ones recommended for the general population, but you may need to adapt them around pain and fatigue.
🔷 Know Your Blood Pressure
High blood pressure often causes no obvious symptoms. Regular checks can identify problems before complications develop.
🔷 Check Cholesterol and Blood Sugar
Ask your healthcare professional how often you should have cholesterol, glucose, or HbA1c testing based on your age and personal risk factors.
🔷 Build Activity Slowly
Avoid the cycle of doing almost nothing for days and then attempting an exhausting workout. Start with manageable amounts of movement and increase gradually.
🔷 Prioritize Sleep
Treat sleep as part of cardiovascular care, not just a way to reduce fatigue. Persistent snoring, witnessed pauses in breathing, morning headaches, or severe daytime sleepiness may justify evaluation for sleep apnea.
🔷 Eat for Overall Cardiovascular Health
Focus primarily on vegetables, fruits, whole grains, legumes, nuts, seeds, lean protein sources, and foods rich in unsaturated fats while limiting excessive amounts of highly processed foods, added sugars, and sodium. The diet does not need to be perfect to provide benefits.
🔷 Avoid Smoking
Smoking substantially increases cardiovascular risk and can compound other health problems.
🔷 Manage Stress
Relaxation exercises, gentle movement, cognitive behavioral approaches, mindfulness, counseling, enjoyable hobbies, and supportive relationships may all help reduce the physiological burden of chronic stress.
🔷 Keep Regular Medical Appointments
Fibromyalgia symptoms can dominate appointments because they affect daily life so strongly. Make sure you don’t overlook routine cardiovascular prevention.
Questions to Ask Your Doctor
If you have fibromyalgia and are concerned about your heart, useful questions may include:
- Is my blood pressure within a healthy range?
- Should I have cholesterol or diabetes screening?
- Could my palpitations be related to my medication?
- Should I have an ECG?
- Could my dizziness suggest orthostatic intolerance?
- Is my exercise plan safe?
- Should I be evaluated for a sleep disorder?
- What cardiovascular risk factors should I prioritize?
- Are any of my symptoms inconsistent with fibromyalgia?
These conversations can help separate common fibromyalgia symptoms from conditions that require additional testing.
Fibromyalgia and Heart Health: What the Research Really Means
Research increasingly supports a relationship between chronic widespread pain, autonomic function, and cardiovascular health.
People with fibromyalgia may experience reduced heart-rate variability, altered autonomic regulation, dizziness, postural symptoms, palpitations, reduced physical conditioning, poor sleep, and metabolic factors that can influence cardiovascular well-being.
Population studies have also found higher cardiovascular risk in some groups with fibromyalgia or chronic widespread pain.
But association is not the same as causation.
It would be misleading to say that fibromyalgia automatically causes heart disease.
Instead, fibromyalgia may exist alongside a collection of physiological and lifestyle challenges that make routine cardiovascular prevention especially worthwhile.
Frequently Asked Questions About Fibromyalgia and Heart Health
Can fibromyalgia affect your heart rate?
It may influence heart-rate regulation in some people through autonomic nervous system dysfunction. Studies have reported lower heart-rate variability and altered autonomic activity in fibromyalgia populations, although the degree varies widely between individuals.
Can fibromyalgia cause heart palpitations?
Palpitations can occur in people with fibromyalgia, but they have many potential causes. New or frequent palpitations should be discussed with a healthcare professional rather than automatically attributed to fibromyalgia.
Does fibromyalgia increase heart-attack risk?
Some observational research suggests higher cardiovascular and coronary disease risk among people with fibromyalgia or chronic widespread pain. However, the evidence does not prove that fibromyalgia directly causes heart attacks.
Can fibromyalgia cause chest pain?
Fibromyalgia can involve musculoskeletal pain in the chest region. Chest pain can also result from costochondritis and many other conditions, but consider cardiovascular causes when pain is new or unexplained.
Can fibromyalgia cause high blood pressure?
Chronic pain has been associated with hypertension in population studies, but fibromyalgia does not necessarily cause high blood pressure. Measure blood pressure rather than estimate it from symptoms.
Is exercise safe with fibromyalgia?
Exercise is generally an important part of fibromyalgia management, but you may need to start low and progress gradually. People with significant cardiovascular symptoms or medical conditions should obtain individualized guidance.
Can better sleep improve heart health with fibromyalgia?
Better sleep can support overall health and may reduce cardiovascular risk factors linked to chronic sleep disruption. Persistent sleep difficulties or suspected sleep apnea deserve medical attention.
Final Thoughts: How Fibromyalgia Affects Your Heart Health
Understanding how fibromyalgia affects your heart health requires looking beyond pain alone.
Fibromyalgia appears to interact with the autonomic nervous system, which helps regulate heart rate and blood pressure. Research has repeatedly found differences in heart-rate variability among people with fibromyalgia, while some individuals experience palpitations, dizziness, or postural intolerance.
At the same time, pain, fatigue, disrupted sleep, reduced activity, physical deconditioning, obesity, metabolic problems, and chronic stress can create additional cardiovascular challenges.
Recent research also suggests that chronic widespread pain may be associated with greater atherosclerotic cardiovascular risk, although researchers have not established that fibromyalgia directly causes cardiovascular disease.
The most practical response is therefore proactive heart-health management rather than unnecessary alarm.
Keep track of blood pressure, cholesterol, blood sugar, weight, sleep, exercise tolerance, and other conventional cardiovascular risk factors.
Build physical activity gradually, follow a heart-supportive eating pattern, avoid smoking, and discuss unexplained cardiovascular symptoms with a qualified healthcare professional.
Most importantly, never assume that a new episode of chest pain, severe breathlessness, fainting, or unusual heart symptoms is “just fibromyalgia.”
Taking both fibromyalgia and cardiovascular health seriously gives you the best opportunity to manage symptoms while protecting long-term health.
Reference
https://en.wikipedia.org/wiki/Fibromyalgia
https://www.webmd.com/fibromyalgia/medical-reference/default.htm
https://www.healthline.com/health/fibromyalgia-and-chest-pain
https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780