VCAM1 and atherosclerosis: Activated platelets also promote leukocyte binding of vascular cell adhesion molecule-1 and P-selectin and increase platelet adhesion to atherosclerotic endothelium.24 Circulatory proinflammatory cytokines including C-reactive protein, interleukin-6, and interleukin-1 increase in correlation with activated leukocyte aggregation.25 These phenomena in persons under stress would cause the formation and progression of atherosclerosis and subsequently provoke CAD and CVD development.