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Meta-Analysis
. 2012 Dec 15;110(12):1711-6.
doi: 10.1016/j.amjcard.2012.08.004. Epub 2012 Sep 10.

Meta-analysis of perceived stress and its association with incident coronary heart disease

Safiya Richardson  1 , Jonathan A Shaffer, Louise Falzon, David Krupka, Karina W Davidson, Donald Edmondson
Affiliations
Meta-Analysis

Meta-analysis of perceived stress and its association with incident coronary heart disease

Safiya Richardson et al. Am J Cardiol. .

Abstract

Most studies examining potential associations between psychological factors and cardiovascular outcomes have focused on depression or anxiety. The effect of perceived stress on incident coronary heart disease (CHD) has yet to be reviewed systematically. We conducted a systematic review and meta-analysis of the association between perceived stress and incident CHD. Ovid, MEDLINE, and PsycINFO were searched as data sources. Prospective observational cohort studies were selected that measured self-reported perceived stress and assessed incident CHD at ≥6 months. We extracted study characteristics and estimates of the risk of incident CHD associated with high perceived stress versus low perceived stress. We identified 23 potentially relevant articles, of which 6 met our criteria (n = 118,696). Included studies measured perceived stress with validated measurements and nonvalidated simple self-report surveys. Incident CHD was defined as new diagnosis of, hospitalization for, or mortality secondary to CHD. Meta-analysis yielded an aggregate risk ratio of 1.27 (95% confidence interval 1.12 to 1.45) for the magnitude of the relation between high perceived stress and incident CHD. In conclusion, this meta-analysis suggests that high perceived stress is associated with a moderately increased risk of incident CHD.

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Figures

Figure 1
Figure 1
Search strategy flowchart
Figure 2
Figure 2
High perceived stress and coronary heart disease incidence estimates Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.
Figure 3
Figure 3
Funnel plot to assess publication bias across incidence studies
See this image and copyright information in PMC

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