Key result
Behavioral disengagement is linked to ~8% higher obesity risk, while coping variability reduces risk.
Why the study?
Stress-related coping contributes to cardiovascular disease risk, but its association with upstream cardiometabolic conditions such as hypertension and obesity remained unexplored.
Does the use and variability of stress-related coping strategies predict the onset of hypertension and obesity in women?
Cohort (n=26,126)
Does the use and variability of stress-related coping strategies predict the onset of hypertension and obesity in women?
Hazard Ratio: 1.08 (95% CI 1.05–1.11)
Greater variability in stress-coping strategies is associated with a lower risk of developing obesity and hypertension in women, highlighting a potential behavioral target for cardiovascular prevention.
Should not yet change counseling on stress coping; leaves open trials of strategy variability for obesity and hypertension prevention.
OBJECTIVE: Accumulating research suggests stress-related coping contributes to cardiovascular disease risk, but its association with upstream cardiometabolic conditions remains unexplored. We examined whether coping strategies generally deemed adaptive (e.g., acceptance) and maladaptive (e.g., self-blame), as well as variability in their use (reflecting attempts to find the best strategies for managing stressors) predict risk of developing hypertension and obesity. METHODS: Women (N = 26,126) from the Nurses' Health Study II cohort reported use of eight coping strategies in 2001. Coping variability was operationalized using a standard deviation-based algorithm and considered categorically (i.e., lower, moderate, greater levels) to assess non-linear effects. Until 2019, hypertension status was self-reported and obesity was derived from height and updated weight information. Cox regression models, controlling for baseline demographic, health-related, and behavioral factors, estimated hazard ratios (HR) and 95% confidence intervals (CI). Potential effect modification by age, menopausal status, and neighborhood socio-economic status (SES) was evaluated. RESULTS: In the overall sample, many coping strategies were associated with increased risk of new onset obesity (e.g., per 1-SD increase in behavioral disengagement adjusting for demographic and health-related covariates: HR = 1.08, 95CI% = 1.05-1.11), but not hypertension. Greater versus lower variability levels were related to 8-10% lower risk of developing obesity and hypertension, respectively. Associations were generally comparable across age, menopausal status, and neighborhood SES subgroups. CONCLUSIONS: Stress-related coping strategies and variability in their use were associated with risk of developing obesity and hypertension among women. Future intervention research may consider how women manage stressors to lower risk of conditions that affect lifelong cardiovascular health.
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Trudel-Fitzgerald et al. (2026) conducted a cohort in Hypertension and obesity (n=26,126). Stress-related coping strategies and coping variability vs. Lower use of strategies or lower variability levels was evaluated on New onset obesity (HR 1.08, 95% CI 1.05-1.11). A 1-SD increase in behavioral disengagement increased new-onset obesity risk (HR 1.08; 95% CI 1.05-1.11), whereas greater coping variability lowered obesity and hypertension risk by 8-10%.
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