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Self-peerceived chronic stress and self-rated health as mediating markers for the association with cardiovascular disease risk: The Malmö Preventive Project

Milton, Pär LU ; Persson, Margaretha and Nilsson, Peter M (2012) LÄKM01 20121
MD Programme
Abstract
Cardiovascular (CVD) is one of the most common causes of mortality. Apart from known causal risk factors such as smoking, obesity, dyslipidaemia and hypertension, chronic psychological stress has been suggested as a possible independent risk marker, also because the CVD burden follows a social gradient. Another self-reported variable is self-rated health (SRH) which in many studies has ben shown to predict morbidity and mortality in otherwise healthy subjects.
Aims This study aimed to investigate a possibly interaction effect of self-perceived chronic stress and SRH on CVD risk. We also wanted to investigate if social class modified this effect.
Subjects and methods Data were analyzed from a population based cohort study consisting of... (More)
Cardiovascular (CVD) is one of the most common causes of mortality. Apart from known causal risk factors such as smoking, obesity, dyslipidaemia and hypertension, chronic psychological stress has been suggested as a possible independent risk marker, also because the CVD burden follows a social gradient. Another self-reported variable is self-rated health (SRH) which in many studies has ben shown to predict morbidity and mortality in otherwise healthy subjects.
Aims This study aimed to investigate a possibly interaction effect of self-perceived chronic stress and SRH on CVD risk. We also wanted to investigate if social class modified this effect.
Subjects and methods Data were analyzed from a population based cohort study consisting of 10,868 men and 2741 women from Malmö, southern Sweden, with a mean followed up time for 27 years. Subjects were screened at baseline for traditional biochemical and physical risk factors for CVD and filled a self-administered questionnaire containing ratings of psychological and lifestyle related factors. Subjects were then followed in both national and regional registries for first CVD event. The influence of self-perceived chronic stress and SRH were analyzed in a Cox regression model with stepwise adjustment for other risk factors. Interaction effects between stress/SRH were also tested.
Results In all, 3252 men and 320 women suffered a CVD event during follow-up. In the total co- hort (n=13,609) the hazard ratio for CVD was 1.28 (95% CI; 1.06-1.55) among subjects reporting both chronic stress and poor SRH compared to the reference group (no stress, optimal SRH). Men who reported poor SRH with or without stress had a HR of 1.53 (CI 1.24-1.87) and 1.21 (1.03-1.41) respectively after full adjustments for other risk factors. There were no associations among women. No significant interaction effect between stress/SRH was found in either sex.
Conclusion Self-perceived chronic stress and poor self-rated health are both independent, long- term cardiovascular risk markers in middle-aged men, but not in women. The biological mediators of this increased risk pattern have still not been well characterized. (Less)
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author
Milton, Pär LU ; Persson, Margaretha and Nilsson, Peter M
supervisor
organization
course
LÄKM01 20121
year
type
H2 - Master's Degree (Two Years)
subject
keywords
Cardiovascular disease, cohort, prospective, self-rated health, social class, stress
language
English
id
2968203
date added to LUP
2012-08-24 11:09:53
date last changed
2012-08-24 11:09:53
@misc{2968203,
  abstract     = {Cardiovascular (CVD) is one of the most common causes of mortality. Apart from known causal risk factors such as smoking, obesity, dyslipidaemia and hypertension, chronic psychological stress has been suggested as a possible independent risk marker, also because the CVD burden follows a social gradient. Another self-reported variable is self-rated health (SRH) which in many studies has ben shown to predict morbidity and mortality in otherwise healthy subjects.
Aims This study aimed to investigate a possibly interaction effect of self-perceived chronic stress and SRH on CVD risk. We also wanted to investigate if social class modified this effect.
Subjects and methods Data were analyzed from a population based cohort study consisting of 10,868 men and 2741 women from Malmö, southern Sweden, with a mean followed up time for 27 years. Subjects were screened at baseline for traditional biochemical and physical risk factors for CVD and filled a self-administered questionnaire containing ratings of psychological and lifestyle related factors. Subjects were then followed in both national and regional registries for first CVD event. The influence of self-perceived chronic stress and SRH were analyzed in a Cox regression model with stepwise adjustment for other risk factors. Interaction effects between stress/SRH were also tested.
Results In all, 3252 men and 320 women suffered a CVD event during follow-up. In the total co- hort (n=13,609) the hazard ratio for CVD was 1.28 (95% CI; 1.06-1.55) among subjects reporting both chronic stress and poor SRH compared to the reference group (no stress, optimal SRH). Men who reported poor SRH with or without stress had a HR of 1.53 (CI 1.24-1.87) and 1.21 (1.03-1.41) respectively after full adjustments for other risk factors. There were no associations among women. No significant interaction effect between stress/SRH was found in either sex.
Conclusion Self-perceived chronic stress and poor self-rated health are both independent, long- term cardiovascular risk markers in middle-aged men, but not in women. The biological mediators of this increased risk pattern have still not been well characterized.},
  author       = {Milton, Pär and Persson, Margaretha and Nilsson, Peter M},
  keyword      = {Cardiovascular disease,cohort,prospective,self-rated health,social class,stress},
  language     = {eng},
  note         = {Student Paper},
  title        = {Self-peerceived chronic stress and self-rated health as mediating markers for the association with cardiovascular disease risk: The Malmö Preventive Project},
  year         = {2012},
}