The role of stress in the genesis of coronary heart disease has been difficult to resolve because stress is a nebulous concept that is difficult to define and virtually impossible to measure. Although there are links between psycho-social and emotional stress and cardiovascular disease there is little prospect of reducing coronary heart disease mortality by reducing stress. We should instead concentrate our efforts on identifyting, preventing, and eliminating the factors that create the underlying atheromatous coronary plaques that make us susceptible to the effects of stress.