Mental stress contributes to the pathogenesis of atherosclerotic heart and brain diseases: A mini-review

Atherosclerotic vascular diseases have two life-threatening complications, namely myocardial and cerebral infarcts. The development of the two pathological conditions involves interplays between genetic, epigenetic, and environmental factors. Mental stress is an independent factor that contributes to the pathogenesis of atherosclerotic heart and brain diseases. Increased mental stress is linked to heightened vascular stiffness, inflammation, atherosclerosis, and hypertension. Neuroendocrinological impacts of stress include the involvement of the renin-angiotensin system and its active peptides, particularly angiotensin II (Ang II), in stress-related disorders. In a circadian manner, Ang II and its two subtypes of receptors exist in the stress-responsive brain hypothalamus–adrenal–pituitary axis. Mental stress can cause broken heart syndrome or stress cardiomyopathy. Stress resilience is an important factor that regulates the susceptibility to stress-associated cardiovascular dysfunction and the development of adverse events. Preventive and therapeutic approaches are developed on multiple fronts aimed at mitigating the stress-associated vascular responses and development of atherosclerotic vascular disorders.