Inclusion Criteria:

• Must admit to feeling stressed and/or have PSS score > 13 (moderate stress)
• Must be willing to complete stress reduction course and imaging sessions with < 3 missed appointments in last year
• Known clinical cardiovascular disease with prior atherosclerotic myocardial infarction, percutaneous intervention or bypass surgery > 6 months before entry, or severe coronary calcifications on computed tomography or coronary calcium score >400
• Stable symptoms without symptomatic heart failure or arrhythmia or planned revascularization
• Maximally tolerated and stable medical regimen for 90 days that does not include a high intensity statin for clinical reasons
• No neurological disease or systemic inflammatory disease/current anti-inflammatory therapy
• No active psychiatric disease/medications or substance abuse (including tobacco smoking or more than moderate alcohol) for last 6 months
• No current participation in cardiac rehab or prior participation in stress reduction
• For imaging: no pregnancy, weight > 300 lbs., metal implants, uncontrolled hyperglycemia, or inability to provide consent or comply

History of severe allergic reactions to study medication Currently pregnant or breastfeeding Recent participation in another clinical trial within the last 30 days Presence of uncontrolled medical conditions that could affect safety