Of all occupations, cab drivers face the most risk of being murdered on the job. Farm workers have the highest risk of injury leading to death. Police officers and convenience store clerks also place life and limb in jeopardy while at work. But office-dwelling business executives? They must be in one of the safest occupations around, right? Not necessarily. When left unchecked, the stress of managing a growing company can take its toll in some frightening ways. Howard Hunt, president of Life Management Group Inc., La Jolla, Calif., conducts health assessments at businesses around the country. His data indicate that almost half of all executives have elevated cholesterol levels, a condition that puts them at increased risk for heart disease. Their potential for liver disease --as measured by three key liver functions -- is significantly higher than the general population, usually because of excessive alcohol intake. Furthermore, heart attacks are unfortunately not a rare occurrence among inhabitants of the corner office. Last year alone, five key executives at a major toy manufacturer suffered heart attacks: Two were fatal and two forced the executives into early retirement. In addition to these overt and alarming signs of job stress are more subtle indicators, such as those exhibited by clients of the Executive Health Program at Duke University Medical Center in Durham, N.C. "The most common problems we see in executives are weight gain, headaches, and high blood pressure, as well as emotional distress such as sleep disorders and depression," says Dr. Lisa Giannetto, associate, department of medicine. Face it: It's not easy managing a growing company. Combine 15-hour days with extensive worry about financial commitments, workforce issues, strategic decisions, and competitive pressures, and you have the recipe for a full-blown, stress-related assault on your body, mind, and spirit. What's an overworked executive to do? Not grin and bear it, that's for sure. While it may be easy to ignore your own fitness while working to ensure the health of your company, the two are related. Stress and irritability can impair decision-making, sap your energy, and affect your relationships with others. This, in turn, can create more pressure and problems in the business. Snap at an employee, and you may be facing a lawsuit. Struggle over a decision, and you may lose your competitive edge. Fall ill from exhaustion, and the entire business may flounder. Like it or not, your stress and the health of your business are intertwined. So how do you go about managing the pressures of running a company? How can you balance your life while working in an occupation that is unforgiving in its demands? Start by making stress management a priority, and realize that controlling stress is not just about running 45 minutes every morning, or eating more vegetables, or taking more walks with your spouse. There is no one best way for busy executives to balance their lives and improve their health, say experts. One person may exercise regularly, but overlook family relationships. Another may take time for regular vacations, but not relax on a regular basis. Another may have a rich spiritual life, but neglect physical exercise. To manage stress you need to take a holistic view and determine what areas of neglect may be compromising your health. To get you started, IndustryWeek has compiled the following list of general stress-management suggestions that everyone can -- and should -- follow: Take time for yourself. L. John Mason, president and founder of the Stress Education Center, Cotati, Calif., helps overwhelmed executives manage the strain of management. His first suggestion to clients is to take time for themselves. "Usually, they will argue with me, saying they don't have time," Mason says. "But taking time for yourself actually saves time in the long run. . . . Here's an example. I was working with an executive who had come to me with high blood pressure and stomach problems. During the first session, I gave him 15-minute tapes with guided relaxation exercises so he could experience the benefits of taking time to relax. Unfortunately, he didn't listen to the tapes. He came back for a second session, a third session, and a fourth session, and each time he made some excuse why he was too busy to listen to the tapes. Finally, I told him if he didn't listen to them by the fifth session I was going to fire him as my client. Confronted with the potential of being fired -- of failing -- he decided to listen to the tapes during his morning commute. By the time our fifth session rolled around, he was ecstatic. His stomach problems had improved, he claimed to focus better at work, and he said he was getting eight hours of work ddone in 6.5 hours. By investing 20 minutes in himself every day, he was able to save 1.5 hours. And this is not an atypical response." Recognize the power of your thoughts. According to Ruth Quillian, a licensed clinical psychologist with Duke University Medical Center, stress often results not from outside pressures but from how we perceive those outside pressures. The mere perception of a challenge, she says, is enough for the body to start pumping out hormones, which then signal the body to increase fat supplies in the blood, which then increases blood sugar. All of this is great if you use the body to respond to the challenge -- or get rid of all that extra energy through exercise. But if you're sitting at a desk reading a report that has you upset, this energy-rich blood has nowhere to go. Over time this pattern can lead to high blood pressure that can damage the lining of the blood vessels, which then collect fats in the bloodstream, a process that can lead to heart disease. In short, the whole physical stress cycle starts with how you think about challenges. "If you perceive a threat to your business as a threat to you personally, your adrenal glands will kick in and start causing your body to react to the challenge," she says. "If, however, you perceive such threats as merely interesting challenges to be dealt with, you are much less likely to have stress problems." What executives have to learn to do, she adds, is challenge their basic beliefs. If they believe their personal worth is solely dependent on their business accomplishments, they are setting themselves up for experiencing stress in a negative way. But if they learn to evaluate their self-worth not only by their accomplishments but also by their character, their relationships, and how much they enjoy their moment-to-moment existence, they are likely to perceive things in a more balanced and healthful way. Jim Hanlon, 62, is president and CEO of Harmony Foods Corp., a snack and candy manufacturer in Santa Cruz, Calif. With decades of management experience behind him, he's learned not to take things too seriously. "I use my worrying time very carefully," he says, "and I refuse to worry about things I can't do anything about. Furthermore, I realize that nothing I do here is life threatening. We're making candy, after all, and I try to keep that in perspective." Get regular exercise. Because the body is hard-wired to react to stressful situations in a physical, fight-or-flight way, the best way to prevent the physical damage caused by stress is to use up all that energy-rich blood through exercise. Harmony Foods' Hanlon gets up and does 20 minutes of calisthenics every morning followed by a brief jog in his neighborhood. "I walk into work clear-headed every day," he says. Peter Metcalf, 45, CEO of Black Diamond Equipment Ltd., a mountaineering equipment manufacturer in Salt Lake City, runs for an hour almost every day, usually on his lunch break. "I come back to the office more energized, more relaxed . . . ," he says. And Doug Walker, 49, chairman and CEO of WRQ Inc., an Internet software company based in Seattle, rides his bike 10 miles to and from work daily -- something he has done every day, rain or shine, for the last nine years. How has it affected him? "I have a lot more endurance than many younger people," he says. "I can go on a business trip where I visit three countries a day for 10 days and keep going when a lot of others can't." As the experiences of these CEOs indicate, how you exercise and how much you exercise will depend on your age, interests, and lifestyle. The important thing is to find a system that works for you. Cultivate relationships. One of the things people tend to do when they are overwhelmed with job demands is to neglect family members and long-time friendships, sometimes to the point of isolation. But isolation and lack of social support can damage your health as much as lack of exercise. "You have twice as much likelihood of dying from a coronary event if you don't have a significant confidante," Duke's Quillian says. "Often people get so busy they don't even realize they are lonely until some event forces them to stop and look at their lives." For Metcalf that event came about a year ago when his wife told him in no uncertain terms that she would leave him if he didn't cut back his hours at work. Today, instead of logging 70 hours a week, he's down to 50 hours. He now makes breakfast for his kids, sees them off to school, telecommutes from home once in a while, and his family life is a "helluva lot better," he says. Not only has Metcalf's home life improved, his business has seen improvements as well. "My management team was much more capable than I gave them credit for," he says. "Now, because I've given up some responsibilities, they've risen to the challenge." Develop your spiritual side. Even with extensive social support, being an executive can be a lonely and isolating job. Left alone with your thoughts and worries about business, it's all too easy to begin to think of yourself as the center of the universe. This has the potential to increase the amount of stress you already feel. Quillian suggests that one way executives can gain a sense of perspective about their lives and their worries is by developing their spiritual side. This can be anything from following a regular religious practice to meditating every day to being out in nature early in the morning. "It's about doing something that will help you get in touch with an entity larger than yourself," she says. Walker, who admits he is not a devoutly religious man, says he finds peace and perspective in nature. He even plans vacations around outdoor activities such as climbing Mt. Rainier or kayaking in Glacier Bay. "I'm kind of an environmentalist," he says. "I like nature, animals, and this is where I rejuvenate." Schedule regular doctor visits. To ensure stress is not affecting your physical health, experts agree that executives should get annual physical checkups that minimally include four things: a 24-panel blood chemistry, body-fat measurement, blood-pressure readings, and heart-rate assessments. "Eighty-five percent of health problems typically experienced by people in this country can be picked up with these four series of tests," Hunt explains. Forget perfection. It's a fact of executive life that the same qualities that produce professional success often get in the way of fitness success. After all, executives typically are committed perfectionists who give it all they've got -- and then some. Woody Benson, president and CEO of MCK Communications Inc., a telecommunications equipment company based in Needham, Mass., personifies this attitude. "I always try to focus on what can be done better," he says. Although this dogged determination can be great for your company's bottom line, it can backfire where your health is concerned. Why? Because when it comes to stress management, you don't have to run several miles every morning, eat a perfect low-fat diet, go to church every Sunday, and spend long, romantic weekends with your spouse to be successful. After all, stress management is not about competition. It's about keeping you fit to compete. You simply have to make stress management a priority, however it works into your schedule. Making small changes can have a big impact, not only on your quality of life, as Metcalf found when he started spending more time with his family, but also on the quality of your business. "I'm always amazed by how fascinated employees are with every aspect of the CEO's life," Hanlon says. "They are real sensitive to what we think and do, and if we are under pressure, it can spread like a virus." Conversely, when CEOs take care of themselves, employees tend to follow suit. Metcalf's daily run is such a role model to employees that throughout Black Diamond Equipment you'll find employees taking breaks and playing hacky sack, doing pull-ups, or getting ready for a run themselves. "Being very mercenary, one of the benefits of staying fit myself is that it inspires employees to make their health a priority, and this keeps our insurance rates down," Metcalf says. "But not only that, it reduces sick days, improves productivity, and generally makes this an enjoyable place to work. It's good for business to have a healthy workforce, and it all starts with the boss."