Depression, psychological stress, vascular dysfunction, and cardiovascular disease: thinking outside the barrel

THE STRESS RESPONSE is present not only in humans and other mammals but also in more primitive species such as fish (5). It is often said that the accomplishment of some tasks is “easier than shooting fish in a barrel. ” However, the potential out-comes of this scenario are not so optimistic from the viewpoint of the fish. In humans, psychological stress, hopelessness, and depression can be risk factors for disastrous cardiovascular events such as stroke, coronary ischemia, and myocardial infarction (8). These conditions can be silent killers, as evi-denced by cases where extremely fit individuals without known risk factors suffer sudden catastrophic events such as heart attacks under conditions of sustained stress, either external or self-imposed. The study by d’Audiffret and coworkers in this issue of the Journal of Applied Physiology (2) employs a variety of cardiovascular measurements in a comprehensive