Chronic life stress had no significant direct relationship with coronary artery calcification (OR 0.93; 95% CI 0.80-1.08), but was related through indirect pathways of unhealthy lifestyle behaviors.
Cross-Sectional (n=5,773)
Does chronic life stress increase the risk of sub-clinical atherosclerosis in middle-aged adults without clinical cardiovascular disease?
Chronic life stress contributes to subclinical atherosclerosis indirectly through unhealthy coping behaviors such as smoking, sedentary lifestyle, and poor diet leading to obesity.
Odds Ratio: 0.93 (95% CI 0.8–1.08)
OBJECTIVE: To examine the relationship between a general measure of chronic life stress and atherosclerosis among middle aged adults without clinical cardiovascular disease via pathways through unhealthy lifestyle characteristics. METHODS: We conducted an analysis of The Multi-Ethnic Study of Atherosclerosis (MESA). The MESA collected in 2000 includes 5,773 participants, aged 45-84. We computed standard regression techniques to examine the relationship between life stress and atherosclerosis as well as path analysis with hypothesized paths from stress to atherosclerosis through unhealthy lifestyle. Our outcome was sub-clinical atherosclerosis measured as presence of coronary artery calcification (CAC). RESULTS: A logistic regression adjusted for potential confounding variables along with the unhealthy lifestyle characteristics of smoking, excessive alcohol use, high caloric intake, sedentary lifestyle, and obesity yielded no significant relationship between chronic life stress (OR 0.93, 95% CI 0.80-1.08) and CAC. However, significant indirect pathways between chronic life stress and CAC through smoking (p = .007), and sedentary lifestyle (p = .03) and caloric intake (.002) through obesity were found. CONCLUSIONS: These results suggest that life stress is related to atherosclerosis once paths of unhealthy coping behaviors are considered.
Mainous et al. (2010) conducted a cross-sectional in middle aged adults without clinical cardiovascular disease (n=5,773). Chronic life stress was evaluated on Sub-clinical atherosclerosis measured as presence of coronary artery calcification (CAC) (OR 0.93, 95% CI 0.80-1.08). Chronic life stress had no significant direct relationship with coronary artery calcification (OR 0.93; 95% CI 0.80-1.08), but was related through indirect pathways of unhealthy lifestyle behaviors.