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Mental Stress-Induced Myocardial Ischemia: Prevalence, Clinical Significance, and Treatment Implications

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Handbook of Cardiovascular Behavioral Medicine

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Abstract

Mental stress produces myocardial ischemia in a significant subgroup of patients with coronary heart disease (CHD), with prevalence estimates ranging from 20% to 70% in patients with CHD. Several biobehavioral factors are involved in mental stress-induced myocardial ischemia, including autonomic nervous system activation, neuroendocrine responses, and central nervous system-related processes in multiple systems, factors that increase cardiac demand and reduce coronary supply. Mental stress-induced myocardial ischemia is associated with an increased risk of subsequent poor prognosis and mortality. Both pharmacologic and non-pharmacologic interventions targeted at reducing mental stress-induced ischemic responses may be required in the management of patients with CHD. More studies are needed to identify effective interventions as well as understand the underlying pathological pathways between the brain and the heart.

Supported, in part, by grants HL080664, HL 093374, and HL080664 from the National Heart, Lung, and Blood Institute.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    James A. Blumenthal, Jenny T. Wang & Andrew Sherwood

  2. Departments of Psychiatry and Behavioral Sciences and Medicine, Duke University Medical Center, Durham, NC, USA

    Wei Jiang

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  2. James A. Blumenthal
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  3. Jenny T. Wang
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  4. Andrew Sherwood
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Corresponding author

Correspondence to Wei Jiang .

Editor information

Editors and Affiliations

  1. Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA

    Shari R. Waldstein

  2. Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands

    Willem J. Kop

  3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Edward C. Suarez

  4. Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    William R. Lovallo

  5. Division of Gerontology Geriatrics and Palliative Medicine Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Leslie I. Katzel

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© 2022 The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature

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Jiang, W., Blumenthal, J.A., Wang, J.T., Sherwood, A. (2022). Mental Stress-Induced Myocardial Ischemia: Prevalence, Clinical Significance, and Treatment Implications. In: Waldstein, S.R., Kop, W.J., Suarez, E.C., Lovallo, W.R., Katzel, L.I. (eds) Handbook of Cardiovascular Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-85960-6_46

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