Psychological stress-induced vascular changes in patients with coronary artery disease could greatly increase the risk of death and MI, a groundbreaking US study has found.

The findings, published in JAMA Cardiology, provide further backing for a link between mental stress and disease progression in older adults with heart disease, the researchers say.

They recruited 569 patients (mean age 63) with stable coronary artery disease (CAD) who underwent a public speaking test to investigate the association between mental stress-induced endothelial dysfunction – measured via brachial artery flow-mediated vasodilation – and adverse CV outcomes.

More than 70% of participants were using beta blockers at baseline, and the cohort was followed up for an average of three years.