Although psychological stress has been linked to cardiovascular disease risk for years, our understanding of the connection continues to grow. Dr. Ahmad Tawakol and colleagues at Massachusetts General Hospital in Boston presented information at the 2016 American College of Cardiology sessions from a study they did in 293 patients who had PET/CT scans between 2005 and 2008. Subjects who had evidence of cancer, established cardiovascular disease or who were younger than age 30 were excluded. This first-of-kind study revealed a relationship between amygdala activity in the brain, associated with stress and fear, and arterial inflammation. In addition to objective measurements of brain activity, the scans allowed for measurements in arteries and bone marrow. Over approximately a 5 year study period and after correction for cardiovascular risk factors based on Framingham Risk and age and gender, investigators found that 35% of the subjects in the high amygdala activity group had a cardiovascular event, whereas only 5% in the low amygdala activity group suffered such. Dr. Tawakol proposed that perhaps the activation of the amygdala, bone marrow, and arterial inflammation together contribute to a mechanism that may lead to cardiovascular events. In his concluding remarks, Dr. Tawakol stated that the risk of heart disease linked to stress is on par with other major risk factors. Further studies are needed, but perhaps those of us interested in the prevention of cardiovascular events might want to evaluate inflammatory biomarkers in our patients who are under stress in an effort to uncover hidden risk and/or subclinical cardiovascular disease.