Evidence map›Paper›PMID 34102426›Full record

ReviewAtherosclerosis2021

Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient.

Viola Vaccarino, Amit J Shah, Puja K Mehta, Brad Pearce, Paolo Raggi, J Douglas Bremner, Arshed A Quyyumi

Open access · greenAbstract readReview
In one paragraph

Review in Atherosclerosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed
9.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 88 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Review
  6. Mental stress as a trigger of cardiovascular events: A narrative review.European journal of clinical investigation · 2026
    Review
  7. Article
  8. The less lonely and the more satisfied you are, the merrier is … the heart!European heart journal. Quality of care & clinical outcomes · 2025
    Article
  9. Article
  10. Review
  11. Review
  12. Stress-related genetic factors modify the effect of socioeconomic status on cardiovascular risk.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025
    Article
  13. Article
  14. Review
  15. Article
  16. Psychosocial stress and cardiovascular disease.American journal of preventive cardiology · 2025
    Review
  17. Article
  18. Article
  19. Article
  20. Cardiac Response to Stress: Influence of Vortioxetine.Arquivos brasileiros de cardiologia · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Viola VaccarinoDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: viola.vaccarino@emory.edu.
Amit J ShahDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.
Puja K MehtaEmory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
Brad PearceDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Paolo RaggiDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
J Douglas BremnerAtlanta VA Medical Center, Decatur, GA, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Arshed A QuyyumiEmory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: aquyyum@emory.edu.
Emory University · US

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Serious Hazards of Transfusion & Cellular Therapies: Mechanisms and InterventionP01HL086773 · NHLBI · EMORY UNIVERSITY · PI EASLEY, KIRK · 2008 to 2019
$17.9M
Vascular Responses During Mental StressP01HL101398 · NHLBI · EMORY UNIVERSITY · PI QUYYUMI, ARSHED A · 2010 to 2015
$11.0M
J: NRSA Training CoreTL1TR002382 · NCATS · EMORY UNIVERSITY · PI HENRY M BLUMBERG, Vasiliki Michopoulos · 2017 to 2026
$8.5M
Mental Stress and Myocardial Ischemia after MI: Sex Differences, Mechanisms and PrognosisR01HL109413 · NHLBI · EMORY UNIVERSITY · PI VACCARINO, VIOLA · 2012 to 2023
$6.9M
Multidisciplinary Research Training to Reduce Inequities in Cardiovascular HealthT32HL130025 · NHLBI · EMORY UNIVERSITY · PI Tené T Lewis, Viola Vaccarino · 2016 to 2026
$6.4M
Institute for Clinical and Translational ResearchUL1TR000424 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2012 to 2012
$6.0M
Neural Circuits in Women with Abuse and PTSDR01MH056120 · NIMH · YALE UNIVERSITY · PI BREMNER, JAMES DOUGLAS · 1999 to 2011
$5.0M
Mechanisms Linking Depression to Cardiovascular RiskR01HL068630 · NHLBI · EMORY UNIVERSITY · PI VACCARINO, VIOLA · 2001 to 2010
$4.8M
Emory University BIRCWH ProgramK12HD085850 · NICHD · EMORY UNIVERSITY · PI OFOTOKUN, IGHOVWERHA, STERK, CLAIRE E · 2015 to 2023
$4.4M
Metabolomics of subclinical and clinical cardiovascular diseaseP20HL113451 · NHLBI · EMORY UNIVERSITY · PI JONES, DEAN PAUL · 2012 to 2016
$4.3M
NCATS NIH HHS KL2 TR000455NCATS NIH HHS TL1 TR002382NCATS NIH HHS UL1 TR000424NCATS NIH HHS UL1 TR000454NCATS NIH HHS UL1 TR002378NCRR NIH HHS S10 RR016917NHLBI NIH HHS K23 HL127251NHLBI NIH HHS K24 HL077506NHLBI NIH HHS P01 HL086773NHLBI NIH HHS P01 HL101398NHLBI NIH HHS P20 HL113451NHLBI NIH HHS R01 HL068630NHLBI NIH HHS R01 HL088726NHLBI NIH HHS R01 HL109413NHLBI NIH HHS R01 HL125246NHLBI NIH HHS R01 HL136205NHLBI NIH HHS R21 HL093665NHLBI NIH HHS R56 HL126558NHLBI NIH HHS T32 HL130025NIA NIH HHS R01 AG026255NICHD NIH HHS K12 HD085850NIDA NIH HHS UG3 DA048502NIMH NIH HHS K24 MH076955NIMH NIH HHS R01 MH056120NIMH NIH HHS R01 MH120262NIMH NIH HHS T32 MH067547RRD VA I01 RX003418
6 · The paper itself

Abstract

The influence of psychological stress on the physiology of the cardiovascular system, and on the etiology and outcomes of cardiovascular disease (CVD) has been the object of intense investigation. As a whole, current knowledge points to a "brain-heart axis" that is especially important in individuals with pre-existing CVD. The use of acute psychological stress provocation in the laboratory has been useful to clarify the effects of psychological stress on cardiovascular physiology, immune function, vascular reactivity, myocardial ischemia, neurobiology and cardiovascular outcomes. An emerging paradigm is that dynamic perturbations of physiological and molecular pathways during stress or negative emotions are important in influencing cardiovascular outcomes, and that some patient subgroups, such as women, patients with an early-onset myocardial infarction, and patients with adverse psychosocial exposures, may be at especially high risk for these effects. This review summarizes recent knowledge on mind-body connections in CVD among cardiac patients and highlights important pathways of risk which could become the object of future intervention efforts. As a whole, this research suggests that an integrated study of mind and body is necessary to fully understand the determinants and consequences of CVD.

Indexed as

Cardiovascular DiseasesCardiovascular SystemMyocardial IschemiaBrainFemaleHeartHumansStress, PsychologicalCardiovascular diseaseInflammationMyocardial ischemiaPrognosisPsychological stressVascular function

Identifiers

PMID34102426
PMCPMC8254768
OpenAlexW3172322378

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.