The Role of Different Domains of Perceived Stress in the Development of Cardiovascular Events: A Cohort Study

Abstract

Background:Long-term distress plays a crucial role in the development and prognosis of cardiovascular events (CVEs). The current study aims to evaluate the role of distress and its domains in the pathogenesis of CVE. Materials and Methods:This study is part of the Isfahan Cohort Study conducted on 3283 healthy individuals in 2007-2015 to assess the distress level, domains of perceived stressors, and their correlation with CVE development. The demographic and lifestyle characteristics of the studied population were recorded. General Health Questionnaire-12 (GHQ-12) and the Stressful Life Event questionnaire (SLE) were applied to investigate the stress level and its domains, respectively. Kaplan-Meier plots were depicted to show the correlation of CVE incidence with both stress statuses at study entry and the perceived stress level within the 8-year follow-up. Results:The logistic regression assessments showed that the stress score was an independent predictor for CVEs incidence in both crude model (P value = 0.001; OR: 1.08; 95CI: 1.03-1.13) and by controlling the sociodemographic (P value = 0.004; OR: 1.08; 95CI: 1.02-1.12) and lifestyle factors (P value = 0.001; OR: 1.07; 95CI: 1.01-1.13). Domains, including home life, financial problems, personal conflicts, loss and separation, and health concerns, were independently associated with CVEs incidence regardless of sociodemographic and lifestyle factors (P value < 0.05). Conclusions:The current study represented an independent role for long-term distress in the development of CVEs. Besides, home life, financial problems, personal conflicts, loss and separation, and health concerns were the major long-term perceived stressors responsible for CVE development.