Evaluating the impact of stress on systemic disease: the MOST protocol in primary care

J Am Osteopath Assoc. 2003 May;103(5):239-46.


Mental stress has an enormous impact on physical health. This impact commonly manifests as headache, muscle tension, acne, peptic ulcer disease, or a compromised immune system. Stress is also associated with more serious adverse effects, such as cardiovascular disease and exacerbations of rheumatoid arthritis and systemic lupus erythematosus. As these effects are far-reaching, it is important for primary care physicians to identify and manage the symptoms of mental stress in their patients. This is increasingly possible with office-based mental stress testing, which uses cardiovascular markers to identify patients who are overresponders to mental stress, and, thus, at risk for stress-induced disorders. Mental stress in this population can be managed with nonpharmacologic and pharmacologic interventions to improve patients' responses to stress and decrease morbidity and mortality associated with this condition.

Publication types

  • Review

MeSH terms

  • Adaptation, Physiological
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / psychology
  • Escape Reaction / physiology
  • Humans
  • Occupational Diseases / etiology*
  • Occupational Diseases / psychology
  • Prevalence
  • Primary Health Care / methods
  • Stress, Psychological / complications*
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / physiopathology
  • Stress, Psychological / prevention & control
  • United States / epidemiology