Mental stress, arterial stiffness, central pressures, and cardiovascular risk.

To the Editor: We read with great interest the meta-analysis by Chida and Steptoe1 linking poor responses to mental stress with future cardiovascular (CV) risk. The authors eloquently present the pros and cons of laboratory tests that are used to provoke stress, highlight the importance of immediate response to stimuli, as well as of subsequent poststress recovery, and focus on published studies that present longitudinal data regarding CV risk of the subjects that were exposed to the stressor test. In longitudinal studies, the choice of end points and surrogate markers for assessing the effect of interventions is …