This brief paper presents an integrative framework helpful in understanding the relationships between stress and cardiovascular disease risk behaviours. Key concepts such as cardiovascular reactivity, type A behaviour and hostility, ways of coping with both life and illness-related stressors, and the challenges associated with changing risk behaviours can support a patient's behaviour change efforts if communicated in a personally salient manner. Assessing the determinants of health behaviour change facilitates tailoring of interventions and can more precisely identify a patient's needs for referral to a psychologist with expertise in health behaviour issues.