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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Cardiol. May 26, 2026; 18(5): 119108
Published online May 26, 2026. doi: 10.4330/wjc.v18.i5.119108
Mental stress: A novel cardiovascular risk factor
Maurizio Giuseppe Abrignani, Nicolò Renda, Vincenzo Abrignani, Alberto Lombardo, Fabiana Lucà
Maurizio Giuseppe Abrignani, Operative Unit of Cardiology, P. Borsellino Hospital, ASP Trapani, Marsala 91025, Trapani, Italy
Nicolò Renda, Operative Unit of Psychiatry, Mental Health Department, ASP 2 Caltanissetta, Caltanissetta 93100, Sicilia, Italy
Vincenzo Abrignani, Operative Unit of Internal Medicine, P. Borsellino Hospital, ASP Trapani, Marsala 91025, Trapani, Italy
Alberto Lombardo, Operative Unit of Cardiology, S. Antonio Abate Hospital, ASP Trapani, Erice 91100, Trapani, Italy
Fabiana Lucà, Department of Cardiology, Grande Ospedale Metropolitano di Reggio Calabria, A.O. Bianchi Melacrino Morelli, Reggio di Calabria 89121, Calabria, Italy
Author contributions: Abrignani MG conceptualized and designed the study, created the artwork, supervised, and made critical revisions; Renda N, Abrignani V, Lombardo A, and Lucà F conducted the literature review, did the analysis, interpretation of data and drafted the original manuscript; and authors gave substantial contributions to conception and design of the study, acquisition of data, or analysis and interpretation of data, drafted the article or made critical revisions related to important intellectual content of the manuscript, and provided final approval of the version of the article to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Maurizio Giuseppe Abrignani, MD, Operative Unit of Cardiology, P. Borsellino Hospital, ASP Trapani, 175 Via Salemi, Marsala 91025, Trapani, Italy. maur.abri@alice.it
Received: January 19, 2026
Revised: February 17, 2026
Accepted: April 23, 2026
Published online: May 26, 2026
Processing time: 120 Days and 8.5 Hours
Core Tip

Core Tip: Many acute coronary syndromes and strokes occur in patients without traditional risk factors. This highlights the growing importance of psychosocial factors, especially mental stress, as recognized by recent guidelines. Acute stress can trigger severe cardiovascular (CV) events, while chronic stress - often linked to ongoing personal or professional issues - promotes inflammation and endothelial dysfunction, contributing to atherosclerosis. Mental stress tests can induce transient myocardial ischemia even without significant coronary obstruction. Therapeutic strategies targeting stress reduction may help lower CV risk. This narrative review synthesizes epidemiological data and explores potential mechanisms regarding interactions between stress and CV disease, outlining future research directions.

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