The importance of heart and artery disease as a cause of death and disability is difficult to exaggerate: it causes over half of all deaths in the western world and now accounts for one-quarter of deaths in the entire world. This appalling incidence persists in spite of commendable progress in treatment and prevention, particularly in the last two or three decades. Deaths from coronary disease have decreased by a third in the past twenty years and stroke has decreased by a half in the same period. This remarkable improvement, saving thousands of lives per year, has come about due to changes...

It has been known or suspected for centuries that there is an association between mind and emotions and the occurrence of heart disease apd sudden death. During the past fifty years this relationship has become identified with the concept of Stress, a notion developed and popularized by Hans Selye. In recent years there has been an upward surge of interest in stress by scientists in several disciplines and by the general public. Although, books, journal articles, seminars and media programs devoted to stress now abound, the definition, manifestations, mechanisms, and management of stress...

A recent comprehensive study of stress and human health by the Institute of Medicine/National Academy of Sciences concludes that individuals who experience any of a wide range of stressful events or situations are at increased risk of developing a physical or mental disorder, including heart disease. Since cardiovascular disease continues to be a leading cause of illness and death, and since the etiology and pathogenesis of several of the commonest forms of heart disease are incompletely known, it is of fundamental impor tance to study the potential role of stress in the genesis of heart...