Emotional Factors in Coronary Heart Disease

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Abstract
The G. Lyman Duff Lecture, delivered Oct. 20, 1960, at the Fourteenth Annual Meeting of the American Society for the Study of Arteriosclerosis St. Louis, Missouri. Some investigators have emphasized the role of emotional stress among the etiological factors in coronary atherosclerosis. This stress has been considered to be something peculiar to Western civilization and as correlating with the high incidence of coronary disease in this part of the world. Similarly it has been implicated in coronary thrombosis. Such an opinion seems unsubstantiated. Emotional stress is ubiquitous. Patients are described illustrating the absence of either acceleration of overt coronary disease or recurrence of coronary occlusion under continued or increased nervous tension. Genetic influences are paramount in atherosclerosis and environmental factors other than emotional stress appear to be much more significant in its development.