Associations of chronic stress burden, perceived stress, and traumatic stress with cardiovascular disease prevalence and risk factors in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

Linda C Gallo, Scott C Roesch, Addie L Fortmann, Mercedes R Carnethon, Frank J Penedo, Krista Perreira, Orit Birnbaum-Weitzman, Sylvia Wassertheil-Smoller, Sheila F Castañeda, Gregory A Talavera, Daniela Sotres-Alvarez, Martha L Daviglus, Neil Schneiderman, Carmen R Isasi
Psychosomatic Medicine 2014, 76 (6): 468-75

OBJECTIVE: The current study examined multiple stress indicators (chronic, perceived, traumatic) in relation to prevalent coronary heart disease, stroke, and major cardiovascular disease (CVD) risk factors (i.e., diabetes, dyslipidemia, hypertension, and current smoking) in the multisite Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (2010-2011).

METHODS: Participants were 5313 men and women 18 to 74 years old, representing diverse Hispanic/Latino ethnic backgrounds, who underwent a comprehensive baseline clinical examination and sociocultural examination with measures of stress.

RESULTS: Chronic stress burden was related to a higher prevalence of coronary heart disease after adjusting for sociodemographic, behavioral, and biological risk factors (odds ratio [OR; 95% confidence interval], 1.22 [1.10-1.36]) and related to stroke prevalence in the model adjusted for demographic and behavioral factors (OR [95% confidence interval], 1.26 [1.03-1.55]). Chronic stress was also related to a higher prevalence of diabetes (OR = 1.20 [1.11-1.31]) and hypertension (OR = 1.10 [1.02-1.19]) in individuals free from CVD (n = 4926). Perceived stress (OR = 1.03 [1.01-1.05]) and traumatic stress (OR = 1.15 [1.05-1.26]) were associated with a higher prevalence of smoking. Participants who reported a greater number of lifetime traumatic events also unexpectedly showed a lower prevalence of diabetes (OR = 0.89 [0.83-0.97]) and hypertension (OR = 0.88 [0.82-0.93]). Effects were largely consistent across age and sex groups.

CONCLUSIONS: The study underscores the advantages of examining multiple indicators of stress in relation to health because the direction and consistency of associations may vary across distinct stress conceptualizations. In addition, the study suggests that chronic stress is related to higher CVD risk and prevalence in Hispanics/Latinos, the largest US ethnic minority group.

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