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. 2024 Jan;43(1):58-66.
doi: 10.1037/hea0001333. Epub 2023 Nov 2.

Psychological stress and the longitudinal progression of subclinical atherosclerosis

Chrystal Spencer  1 , Rebecca G Reed  1 , Elizabeth Votruba-Drzal  1 , Peter J Gianaros  1
Affiliations

Psychological stress and the longitudinal progression of subclinical atherosclerosis

Chrystal Spencer et al. Health Psychol. 2024 Jan.

Abstract
in English, Spanish

Objective: In a midlife sample of adults, the present study tested the extent to which changes in psychological stress relate to the progression of subclinical cardiovascular disease over multiple years and explored the potential moderating role of cardiometabolic risk.

Method: Participants were screened to exclude those with clinical cardiovascular, respiratory, metabolic, and other chronic illnesses, as well as those taking psychotropic, cardiovascular, lipid, and glucose control medications. At baseline (N = 331) and then again at follow-up an average of 3 years later (N = 260), participants completed the 10-item Perceived Stress Scale, underwent assessments of their cardiometabolic risk, and underwent ultrasonography to measure carotid artery intima-media thickness (IMT), which is a surrogate indicator of subclinical atherosclerosis.

Results: Regression models showed that the change in psychological stress from baseline to follow-up was positively associated with the corresponding change in IMT, with covariate control for age at baseline, sex at birth, and variability in length of follow-up across participants. Cardiometabolic risk factors did not statistically moderate this longitudinal association. In exploratory analyses, cardiometabolic risk factors also did not statistically mediate this association.

Conclusion: These longitudinal findings suggest that increases in psychological stress in midlife relate to corresponding increases in subclinical atherosclerosis. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objevo:: En una muestra de adultos de mediana edad, el estudio presente probó el grado en que los cambios en el estrés psicológico se relacionan con la progresión de la enfermedad cardiovascular subclínica durante varios años y exploró el posible papel moderador del riesgo cardiometabólico.

Método:: Los parcipantes fueron evaluados para excluir a aquellos con enfermedades clínicas cardiovasculares, respiratorias, metabólicas y otras enfermedades crónicas, así como a aquellos que tomaban medicamentos psicotrópicos, cardiovasculares, de lípidos y de control de glucosa. Al inicio (N = 331) y luego nuevamente en el seguimiento, un promedio de 3 años después (N = 262), los parcipantes completaron la Escala de Estrés Percibido de 10 ítems, se someeron a evaluaciones de su riesgo cardiometabólico y a una ecograa para medir el grosor de ínma-media carotídeo (IMT por sus siglas en inglés), que es un indicador sustuto de la aterosclerosis subclínica.

Resultados:: Los modelos de regresión mostraron que el cambio en el estrés psicológico desde el inicio hasta el seguimiento se asoció posivamente con el cambio correspondiente en el IMT, con control de covariables para la edad al inicio, el sexo al nacer y la variabilidad en la duración del seguimiento entre los parcipantes. Los factores de riesgo cardiometabólico no moderaron estadíscamente esta asociación longitudinal.

Conclusión:: Estos hallazgos longitudinales sugieren que los aumentos en el estrés psicológico en la mediana edad se relacionan con los aumentos correspondientes en la aterosclerosis subclínica.

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Figures

Figure 1:
Figure 1:
Relationship between multiyear change in psychological stress and IMT. Solid black line represents the line of best fit, and shading represents the 95% confidence interval. Gray triangles represent the 8 participants who were excluded due to a change in medication status from baseline to follow up.
See this image and copyright information in PMC

References

    1. Almeida DM, Rush J, Mogle J, Piazza JR, Cerino E, & Charles ST (2022). Longitudinal change in daily stress across 20 years of adulthood: Results from the national study of daily experiences. Developmental Psychology. 10.1037/dev0001469 - DOI - PMC - PubMed
    1. Arnold SV, Smolderen KG, Buchanan DM, Li Y, & Spertus JA (2012). Perceived Stress in Myocardial Infarction. Journal of the American College of Cardiology, 60(18), 1756–1763. 10.1016/j.jacc.2012.06.044 - DOI - PMC - PubMed
    1. Baldassarre D, Veglia F, Hamsten A, Humphries SE, Rauramaa R, de Faire U, Smit AJ, Giral P, Kurl S, Mannarino E, Grossi E, Paoletti R, & Tremoli E (2013). Progression of Carotid Intima-Media Thickness as Predictor of Vascular Events: Results from the IMPROVE Study. Arteriosclerosis, Thrombosis, and Vascular Biology, 33(9), 2273–2279. 10.1161/ATVBAHA.113.301844 - DOI - PubMed
    1. Benjamini Y, & Hochberg Y (1995). Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. Journal of the Royal Statistical Society. Series B (Methodological), 57(1), 289–300. JSTOR.
    1. Björkegren JLM, & Lusis AJ (2022). Atherosclerosis: Recent developments. Cell, 185(10), 1630–1645. 10.1016/j.cell.2022.04.004 - DOI - PMC - PubMed

Supplementary concepts