Assessment of the cardiovascular effects of stress

The stress response increases sympathetic nervous activity, which can adversely affect the cardiovascular system. Cardiovascular disease is due in part to stress-induced mechanisms mediated primarily through increased adrenergic stimulation. These stress-induced mechanisms include elevations in serum lipid levels, alterations in blood coagulation, atherogenesis, vascular changes in hypertension, and myocardial ischemia. Stress management interventions for hypertension are controversial; however, interventions for coronary heart disease-prone behavior patterns have proven successful. Stress management interventions have also reduced cardiovascular events, mortality, and coronary atherosclerosis. Assessment of stress includes individual interviews, which can be complemented by information derived from questionnaires and mental stress testing. Educational and relaxation strategies can prepare patients to understand and cope with stress. These approaches will hopefully decrease the occurrence of stress and, ultimately, the risk for cardiovascular disease.