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Mental Stress During Daily Life Triggers Myocardial Ischemia
Murray A. Mittleman, MD, DrPH;
Malcolm Maclure, ScD
JAMA. 1997;277(19):1558-1559.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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In this issue of THE JOURNAL, Gullette et al1 report on the relationship between mental stress and myocardial ischemia among patients with documented coronary artery disease and recent evidence of exercise-induced myocardial ischemia. The risk of silent myocardial ischemia within 1 hour of experiencing negative emotions (tension, sadness, and frustration) was elevated between 2 and 3 times compared with periods when the subjects were not experiencing these emotions. Not surprisingly, episodes of heavy physical activity were associated with a much higher (13-fold) increase in risk of ischemia. Unlike prior studies that evaluated the relationship between laboratory-based mental stress tasks and myocardial ischemia,2-5 this study used innovative methods to evaluate the relationship between reallife stressors and episodes of ischemia in free-living subjects.
See also p 1521.
Gullette et al1 used a case-crossover design6,7 to evaluate the change in risk of an episode of myocardial ischemia associated with
. . . [Full Text PDF of this Article]
Author Affiliations
From the Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School (Dr Mittleman); and the Epidemiology Department, Harvard School of Public Health (Drs Mittleman and Maclure), Boston, Mass.
Footnotes
Reprints: Murray A. Mittleman, MD, DrPH, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Autumn St, Fifth Floor, Boston, MA 02215 (e-mail: mitm@episun1.harvard.edu).
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