Mental Stress and Cardio-Cerebrovascular Disease: Research Progress from Mental Stress-Induced Myocardial Ischemia to Stroke – A Narrative Review

Mental stress is a prevalent psychosocial stressor in contemporary society. Recently, its association with myocardial ischemia and cerebrovascular events has received increasing attention. Mental stress-induced myocardial ischemia (MSIMI) can provoke adverse cardiovascular events and acute cerebrovascular events. Mental stress, the heart, and the brain form a feedback loop that interacts through mechanisms including autonomic dysregulation, systemic inflammation, and endothelial dysfunction. Stress management and drug therapy are effective treatments for patients with MSIMI, but comprehensive interventions for stroke patients are still lacking. It is of great significance to propose comprehensive management for such patients. The purpose of the review is to describe the interaction among mental stress, myocardial ischemia, and cerebrovascular events: stress precipitates cerebrovascular injury and stroke, and stroke, in turn, amplifies mental stress burden and induces secondary cardiac injury. This reciprocal brain–heart interaction constitutes a clinically actionable target for integrated prevention and management.