Exhaustion and coronary heart disease: the history of a scientific quest.

This paper describes the development of the concept "vital exhaustion", the epidemiological evidence that this state belongs to the precursors of different manifestations of coronary artery disease, and the biological plausibility of the association between exhaustion and coronary artery disease. It further describes the main results of a randomized, controlled trial designed to determine whether a behavioural intervention reduces the risk of a new coronary event.