Exaggerated pressor responses to mental stress in patients with coronary artery disease (CAD) are associated with increased risk for subsequent cardiovascular events. The integrated baroreflex gain and its mechanical and neural component were estimated and then related to the blood pressure and heart rate responses to simulated real life stressors - mental arithmetic and public speaking. 18 healthy individuals (aged 61 ± 8 years) and 29 individuals with documented CAD but no other co-morbidities (aged 59 ± 8 years) were studied. Heart rate and blood pressures were continuously assessed prior to, during preparation for, and during performance of a math task and a speech task. The assessment of beat-to-beat carotid diameters during baroreflex engagement was used to estimate the integrated baroreflex gain and its mechanical and neural component. The CAD subjects demonstrated significantly greater blood pressures during both preparation for and performance of the speech task (mean arterial pressures: 114 + 9 and 124 + 11 vs. 108 + 11 and 116 + 12 mmHg, P<0.05). However, there were no group differences in integrated cardiovagal baroreflex gain or either mechanical or neural baroreflex component. These findings indicate that the augmented pressor responses in CAD do not result from a generalized arterial baroreflex deficit but may result from greater sympathetic vasoconstrictor outflow.