The Role of Stress in CVD

Authors: Song H et al.

BMJ 2019 Apr 10

Stressful life events (e.g., death of a loved one, illness, trauma) have been associated with excess risk for cardiovascular disease (CVD). In this study from Sweden, researchers used national registries to identify 140,000 patients with diagnosed stress-related disorders (e.g., post-traumatic stress disorder, acute stress reaction, adjustment disorder) from 1987 through 2013. The investigators also identified a sibling cohort (170,000 full siblings without stress-related diagnoses) and a population cohort (10 randomly selected unexposed people for each exposed patient, matched by birth year and sex). Median follow-up times were ≈7 years in each group; results were adjusted for multiple variables.

Patients with stress-related disorders had a 64% higher risk for any CVD during the first year following diagnosis compared with unaffected siblings. Stress patients had excess relative risks for ischemic heart disease, cerebrovascular disease, hypertension, and heart failure. After 1 year, relative risks generally were lower (i.e., 29% excess risk for any CVD). Similar results were obtained for comparisons with matched controls and by specific stress-related disorder. Psychiatric comorbidity did not modify risks.