Psychological Stress As a Risk Factor for Cardiovascular Disease: A Case-Control Study

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2020 Nov 5

PMID 33150108

Citations 11

Authors

Fnu Satyjeet

Sidra Naz

Vinesh Kumar

Norah H Aung

Kanwal Bansari

Sana Irfan

Amber Rizwan

Affiliations

Soon will be listed here.

Abstract

Introduction Stress is a phenomenon elicited in response to certain triggers that may be external or internal. Stress has been identified as a risk factor for various diseases, including cardiovascular disease. In this study, we aim to find an association between psychological stress and cardiovascular disease in the local setting Methods This case-control study was conducted in a tertiary care hospital in Pakistan from June 2019 to December 2019. One hundred and seventeen (117) patients with myocardial infarction and unstable angina were enrolled in the case group. One hundred and ten (110) patient's attendants were enrolled in the study as controlled. Results The risk of a cardiovascular event was higher in patients with a history of social isolation (OR, 2.47), marital stress (OR, 2.28), work stress (OR, 3.2), childhood abuse (OR, 2.78), or trauma (OR, 2.67). Conclusion Psychological stress is an important risk for cardiovascular disease, which is often overlooked. Efforts should be made to include questions related to psychological stress in the history-taking of patients at risk of a cardiovascular event and the management plan should include psychological counseling.

Citing Articles

Atherosclerotic Cardiovascular Diseases in Middle Delta of Egypt: A Systematic Analysis of Risk Factors Associated with the Rising Burden of the Disease.

Khalfallah M, Habib M, Kishk A, Saeed B, Hemdan S, Eissa A Glob Heart. 2025; 20(1):11.

PMID: 39925839 PMC: 11804180. DOI: 10.5334/gh.1395.

Prevalence and Mitigation of Cardiovascular Disease Risk Factors Among the Corporate Workforce in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Bamidele Adelowo A, Lemos Ferreira N, Gupta A, Khan Z Cureus. 2025; 16(12):e75888.

PMID: 39822425 PMC: 11737606. DOI: 10.7759/cureus.75888.

Conceptual Framework for African American Kinship Caregiver's Susceptibility to Alzheimer's Disease.

Washington T, Coley S, Blakey J, Downing K, Wallace Q, Levkoff S Healthcare (Basel). 2024; 12(23.

PMID: 39685001 PMC: 11641078. DOI: 10.3390/healthcare12232379.

Economic and healthcare influences on circulatory diseases in Kazakhstan: a retrospective ecological study.

Zhamantayev O, Smagulov N, Tykezhanova G, Kenzhekeyeva M, Karshalova G J Health Popul Nutr. 2024; 43(1):196.

PMID: 39593183 PMC: 11590314. DOI: 10.1186/s41043-024-00697-y.

Effects of Vibroacoustic Stimulation on Psychological, Physiological, and Cognitive Stress.

Fooks C, Niebuhr O Sensors (Basel). 2024; 24(18).

PMID: 39338668 PMC: 11436230. DOI: 10.3390/s24185924.

References

. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998; 339(19):1349-57. DOI: 10.1056/NEJM199811053391902. View

Bernberg E, Ulleryd M, Johansson M, Bergstrom G . Social disruption stress increases IL-6 levels and accelerates atherosclerosis in ApoE-/- mice. Atherosclerosis. 2012; 221(2):359-65. DOI: 10.1016/j.atherosclerosis.2011.11.041. View

Scott K, Von Korff M, Angermeyer M, Benjet C, Bruffaerts R, de Girolamo G . Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions. Arch Gen Psychiatry. 2011; 68(8):838-44. PMC: 3402030. DOI: 10.1001/archgenpsychiatry.2011.77. View

Zhang T, Chen Y, Liu H, Zhou Z, Zhai Y, Yang J . Chronic unpredictable stress accelerates atherosclerosis through promoting inflammation in apolipoprotein E knockout mice. Thromb Res. 2010; 126(5):386-92. DOI: 10.1016/j.thromres.2010.07.022. View

Dutta P, Courties G, Wei Y, Leuschner F, Gorbatov R, Robbins C . Myocardial infarction accelerates atherosclerosis. Nature. 2012; 487(7407):325-9. PMC: 3401326. DOI: 10.1038/nature11260. View

Zhu Y, Du R, Zhu Y, Shen Y, Zhang K, Chen Y . PET Mapping of Neurofunctional Changes in a Posttraumatic Stress Disorder Model. J Nucl Med. 2016; 57(9):1474-7. DOI: 10.2967/jnumed.116.173443. View

Batty G, Russ T, Stamatakis E, Kivimaki M . Psychological distress and risk of peripheral vascular disease, abdominal aortic aneurysm, and heart failure: pooling of sixteen cohort studies. Atherosclerosis. 2014; 236(2):385-8. DOI: 10.1016/j.atherosclerosis.2014.06.025. View

Cohen B, Edmondson D, Kronish I . State of the Art Review: Depression, Stress, Anxiety, and Cardiovascular Disease. Am J Hypertens. 2015; 28(11):1295-302. PMC: 4612342. DOI: 10.1093/ajh/hpv047. View

Emami H, Singh P, MacNabb M, Vucic E, Lavender Z, Rudd J . Splenic metabolic activity predicts risk of future cardiovascular events: demonstration of a cardiosplenic axis in humans. JACC Cardiovasc Imaging. 2015; 8(2):121-30. PMC: 6855915. DOI: 10.1016/j.jcmg.2014.10.009. View

10.

Tawakol A, Ishai A, Takx R, Figueroa A, Ali A, Kaiser Y . Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study. Lancet. 2017; 389(10071):834-845. PMC: 7864285. DOI: 10.1016/S0140-6736(16)31714-7. View

11.

Wang S, Yan X, Hofman M, Swaab D, Zhou J . Increased expression level of corticotropin-releasing hormone in the amygdala and in the hypothalamus in rats exposed to chronic unpredictable mild stress. Neurosci Bull. 2010; 26(4):297-303. PMC: 5552574. DOI: 10.1007/s12264-010-0329-1. View

12.

LeDoux J, Iwata J, Cicchetti P, Reis D . Different projections of the central amygdaloid nucleus mediate autonomic and behavioral correlates of conditioned fear. J Neurosci. 1988; 8(7):2517-29. PMC: 6569498. View

13.

Lagraauw H, Kuiper J, Bot I . Acute and chronic psychological stress as risk factors for cardiovascular disease: Insights gained from epidemiological, clinical and experimental studies. Brain Behav Immun. 2015; 50:18-30. DOI: 10.1016/j.bbi.2015.08.007. View

14.

Coughlin S . Post-traumatic Stress Disorder and Cardiovascular Disease. Open Cardiovasc Med J. 2011; 5:164-70. PMC: 3141329. DOI: 10.2174/1874192401105010164. View

15.

Steptoe A, Kivimaki M . Stress and cardiovascular disease: an update on current knowledge. Annu Rev Public Health. 2013; 34:337-54. DOI: 10.1146/annurev-publhealth-031912-114452. View

16.

. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994; 344(8934):1383-9. View

17.

Yaribeygi H, Panahi Y, Sahraei H, Johnston T, Sahebkar A . The impact of stress on body function: A review. EXCLI J. 2017; 16:1057-1072. PMC: 5579396. DOI: 10.17179/excli2017-480. View

18.

Nabi H, Kivimaki M, Batty G, Shipley M, Britton A, Brunner E . Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study. Eur Heart J. 2013; 34(34):2697-705. PMC: 3766148. DOI: 10.1093/eurheartj/eht216. View

19.

Orth-Gomer K, Wamala S, Horsten M, Schenck-Gustafsson K, Schneiderman N, Mittleman M . Marital stress worsens prognosis in women with coronary heart disease: The Stockholm Female Coronary Risk Study. JAMA. 2000; 284(23):3008-14. DOI: 10.1001/jama.284.23.3008. View

20.

Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed W . Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004; 364(9438):953-62. DOI: 10.1016/S0140-6736(04)17019-0. View