Your heart is racing, your head is pounding, your knuckles are white from gripping the steering wheel, and the worst part is, you haven't even gotten to work yet. Unfortunately this is an everyday occurrence for millions of Americans who make a long, and often times, very stressful commute to work.

But at what point does it take a toll on your health?

Researchers have found that long periods of time spent behind the wheel can do a lot more than just fray your nerves. This kind of repeated stress can lead to high blood pressure and in severe cases, cause damage to your heart.

"The stress of sitting in traffic causes adrenaline to go up," said Dr. Mary Ann McLaughlin, medical director of the cardiac health program at the Mount Sinai Medical Center in New York. "Adrenaline is a stress hormone, so when adrenaline goes up, blood pressure rises. The issue with car commuters is that there is a constant stress."

Another damaging factor is a lack of exercise.

"People who commute by car tend to walk less than people who commute by trains," McLaughlin said. "People are sitting longer and not exercising a lot during the day because they are spending so much time in their car."

McLaughlin pointed to a study that found train commuters were four times more likely to walk 10,000 steps each workday, then people who drive to work. Fortunately, there are plenty of things you can do to get some daily cardio in.

"If you're near a gym, go around noontime," McLaughlin said. "If you don't have a gym near you, use that time to walk up and down the stairs at your office. Instead of taking the elevator 10 flights, take it five and then walk the rest of the way."

And what about all the research that says most heart attacks occur in the morning? McLaughlin said it's completely true.

"Most heart attacks occur between 4 and 6 a.m.," she said. "It's related to our bodies own stress hormone."

So, how can you make it to work without having a breakdown?

"You can take a lot of stress out of the experience if you allow yourself more time," said Dr. Keith Ablow, a psychiatrist in private practice and Fox News contributor. "Allow yourself to know that this is going to be complicated."

For most people, their commute is very complicated. From traffic jams to aggressive drivers — keeping it cool behind the wheel can be a difficult task. But, it's important to remember that you're not alone out there.

"Treat everyone as a patient," Ablow said. "What I mean is that you should assume that your feelings of being stressed and worried about being late and thinking that people should drive better is shared by other drivers around you."

The bottom line, "You want to adopt a much more passive attitude on the roadways," Ablow said.

He made these suggestions:

1. Again, leave extra time for the commute.

2. Treat people as though they need your kindness.

3. Avoid road rage! Remember you don't know the other people in their cars. So you can't afford to become embroiled in battles with them because they could be dangerous.

4. Remember — you're not late until you are literally supposed to be at work.

5. Make your car a refuge by listening to books on tape or splurging on your favorite music.

If all else fails and the stress of your commute is bleeding into other areas of you life, you might want to make some changes.

"For some people, commuting is going to be the hot button in their lives," Ablow said. "For those people, they should really consider moving closer to work. If commuting is enough of a stress, you need to remove that stress."

According to a new Bizjournals study, people who live in Omaha, Buffalo or Tulsa might be immune to such stresses. The cities are considered the nation's best metro-areas for commuters. The study called Omaha, "a commuter's paradise," where drivers enjoy a mere 20 minute ride to work — the quickest in America during the morning rush. Motorists in Buffalo and Tulsa share similar stress-free treks.

But for the rest of the road warriors out there who risk their sanity to drive in and out of major cities like New York and Washington, D.C., the news isn't so great. In fact, New York City ranks as America's worst metro-area for commuters.

The average morning commute in the New York City metro area is just over 35 minutes — the longest in the country. Nearly 460,000 commuters endure a mind-numbing 90 minute trip to their job — and that's just one way.

The Nation's Capitol comes in a close second, with Atlanta rounding out the top three on the traffic nightmares list.

Click here to see the full survey

Ablow's final advice is to stay positive.

"If you assume it generally takes a long time to get to work and back, just do what you can to make it a reasonable and enjoyable ride," Ablow said. "Therefore you won't be disappointed everyday when you get in your car."