Professor of the Practice of Law University of Denver Sturm College of Law

Stress & Heart Health

When Valentine’s Day approaches, we turn to matters of the heart.

Conditions that contribute to heart disease include high blood pressure, high cholesterol, obesity, diabetes, and lack of physical activity.  Researchers were interested in the impact of mental stress on risk for heart attack or death in people with heart disease.

Ischemia is a condition where blood flow and oxygen are reduced.  Two cohorts of 918 patients with stable heart disease were assessed during mental stress-induced ischemia and physical stress-induced ischemia.  The mental stress test was a public speaking task after 12 hours of fasting.  Participant’s hearts were scanned at rest, during mental stress, and during conventional stress (using myocardial perfusion imaging with single-photon emission computed tomography (SPECT)).  Patients were contacted at multiple follow-up points, and the final follow-up was at 5 years, because stable heart disease is characterized by recurrent nonfatal cardiovascular events.  Researchers also wanted data on heart failure and cardiovascular death to gain a more accurate reflection of the burden of disease. 

Researchers found that mental stress-induced ischemia was significantly associated with elevated risk of adverse cardiovascular events.  The combination of mental stress and conventional stress resulted in even higher risk. 

Takeaway: Mental stress may increase the risk of ischemia, where blood flow and oxygen levels are reduced.  Both the heart and the brain require adequate blood and oxygen flow, so reducing stress is likely to protect both the brain and the heart.


Viola Vaccarino, MD, PhD, et al., Association of Mental Stress‒Induced Myocardial Ischemia With Cardiovascular Events in Patients With Coronary Heart Disease, JAMA. 2021;326(18):1818-1828, Nov 9, 2021,

%d bloggers like this: