Mental Stress–Induced Myocardial Ischemia Is Associated with Increased Risk for Cardiovascular Events

Small studies have shown an association between mental stress–induced myocardial ischemia and an increased risk for cardiovascular events. To evaluate this association, investigators performed a pooled analysis of two prospective cohort studies of patients with stable coronary heart disease (CHD) who underwent both mental stress testing (using a standardized public speaking task) and standard stress testing (exercise or pharmacological).

A total of 918 patients were evaluated (mean age, 60 years; 34% women; 40% Black), of whom 281 (31%) had ischemia induced by conventional stress testing, 147 (16%) had ischemia induced by mental stress testing, and 96 (10%) had ischemia induced by both standard and mental stress testing.

After 5 years of foll…