Table 2 Results of Studies of Stress and Subclinical Cardiovascular Disease in Mid-life Women
From: Women’s heart health at mid-life: what is the role of psychosocial stress?
Author, Year, Study Name/Brief Description | N (% women) | Age Range | Mean Age | Stratified by Sex or tested Stress X Sex Interaction a | Study design | Outcomes | Stress measure | Results | QAT Rating |
|---|---|---|---|---|---|---|---|---|---|
Bomhof-Roordink et al., 2015, Netherlands Study of Depression and Anxiety [58] | 650 (65%) | 20–66 | 46.5 (12.1) | Interaction (n.s.) | Cross-sectional | Carotid bifurcation IMT, Plaque presence, Arterial stiffness (Ultrasound/ Radial applanation tonometry) | Job strain, Negative life events | Recent life stress significantly associated with arterial stiffness but not IMT or plaque, even after adjusting for lifestyle factors. | Good |
Camelo et al., 2015, ELSA-Brasil [64] | 8806 (54%) | 35–74 | Not reported, 47.4% of sample between ages 45–54 | Stratified | Cross-sectional | Carotid IMT (Ultrasound) | Job strain | High strain jobs associated with higher IMT, but not independent of life course SES. Passive work (low control, low demand) also associated with IMT in women. | Good |
Charles et al., 2014, MESA [62] | 1499 (45%) | 45–84 | 56.1 (0.21) | Interaction (n.s.) | Cross-sectional | Flow-mediated dilation (Ultrasound) | Job strain | Job strain, demands, and control not associated with FMD. Occupational category related to FMD in women only. | Good |
Flores-Torres et al., 2017, Mexican Teacher’s Cohort [56] | 634 (100%) | 40+ | Women: 48.9 (4.3) | N/A | Cross-sectional | Carotid IMT, Plaques (Ultrasound) | Life Stressors Checklist (Physical or Sexual violence) | Exposure to physical violence associated with increased IMT and odds of subclinical carotid atherosclerosis. Longer duration of sexual violence associated with IMT. Violence in adulthood, but not childhood, associated with subclinical CVD. | Fair |
Fujishiro et al., 2015, MESA [63] | 3109 (52%) | 45–84 | Women:59.8 (9.4) | Stratified | Prospective | Carotid plaque, IMT progression (Ultrasound) | Job demands, Control, Interpersonal stress | Job strain, interpersonal stress not related to subclinical CVD progression in women. | Good |
Gebreab et al., 2012, Jackson Heart Study [53] | 3980 (63%) | 21–94 | Women:55.1 (12.5) | Stratified | Cross-sectional | Carotid plaque (Ultrasound) | Global Perceived Stress Scale, Holmes & Rahe Life Changes, Jones & Brantley Weekly Stress Inventory | Stress unrelated to presence of plaque in carotid arteries. | Fair |
Janssen et al., 2012, SWAN [65] | 336 (100%) | 48–58 | Women: 50.8 (2.7) | N/A | Prospective | CAC progression (Electron Beam Computed Tomography) | Multiple Role Questionnaire | Stress not related to CAC. Rewarding roles associated with CAC progression in Black women. | Good |
Joseph et al. 2014, AHAB-2 [66] | 281 (48%) | 30–55 | 42.0 (7.3) | Interaction (n.s.) | Cross-sectional | Carotid IMT (Ultrasound) | Marital interaction quality | More negatively-rated interactions with spouses associated with greater IMT. | Good |
Kamarck et al., 2012, Pittsburgh Healthy Heart Study [54] | 270 (54%) | 50–70 | Not available | Interaction (n.s.) | Prospective | Plaque, IMT progression (Ultrasound) | Daily psychological demands | Increased demands in non-hypertensive patients associated with increased plaque, IMT. | Good |
Kershaw et al., 2017, MESA [60] | 2963 (53%) | 45–84 | 61.8 (13.6) | Interaction (n.s.) | Cross-sectional | Flow-mediated dilation (Ultrasound) | Chronic Burden Scale | Chronic stress significantly related to %FMD, but not after adjusting for risk factors. | Good |
Ortega-Montiel et al., 2015, GEA Study [57] | 1243 (67%) | 30–75 | 54.2 (9.0) | Stratified | Cross-sectional | Carotid IMT (Ultrasound) | Chronic self-perceived stress | Higher stress associated with greater IMT in women only. | Fair |
Peterson et al., 2016, SWAN [67] | 1056 (100%) | Not reported | Women: 59.48 (2.7) | N/A | Prospective | Carotid IMT, AD (Ultrasound) | Everyday Discrimination Scale | Cumulative unfair treatment associated with IMT in Caucasian but not minority women. | Good |
Shah et al., 2016, MASALA] [59] | 894 (47%) | 40–84 | Women: 54.4 (8.7) | Stratified | Cross-sectional | Carotid IMT (Ultrasound) | Chronic Burden scale, Everyday Discrimination | Current life stress and life stress over the past six months significantly related to CCA IMT in women only. Everyday discrimination unrelated to IMT in South Asian women. | Good |
Thurston et al., 2014, SWAN [55] | 1402 (100%) | Not reported | Women: 59.6 (2.7) | N/A | Cross-sectional | Carotid IMT, Plaque (Ultrasound) | Childhood physical/Sexual abuse; Adulthood physical/Sexual abuse | Adulthood abuse was related to greater odds of plaque; no associations with IMT. | Good |
Thurston et al., 2018, peri- and post-menopausal women [61] | 272 (100%) | 40–60 | Women: 54 (3.9) | N/A | Cross-sectional | Flow-mediated dilation (Ultrasound) | Brief Trauma Questionnaire, Childhood Trauma Questionnaire | Women with ≥3 trauma exposures in adulthood had worse (lower) FMD; association unchanged after controlling for childhood trauma. | Good |