title: Psychosocial stress and atherosclerosis: family and work stress accelerate progression of coronary disease in women. The Stockholm Female Coronary Angiography Study.
abstract: OBJECTIVE
  To examine the impact of psychosocial stress, experienced in the family and work life, on the progression of coronary atherosclerosis in women cardiac patients.
  
  
  METHODS
  Longitudinal follow-up study. The mean luminal diameter change over 3 years was averaged over 10 predefined coronary segments, representing the entire coronary tree. Stress in family life was measured by using the Stockholm Marital Stress Scale and that of work life by the demand-control questionnaire.
  
  
  METHODS
  Amongst patients enrolled in the Stockholm Female Coronary Angiography Study, 80 women were evaluated for stress exposure and coronary atherosclerosis progression using serial quantitative coronary angiography.
  
  
  RESULTS
  Multi-variable-controlled mixed models anova analyses revealed that women with high stress from either family or work had significant disease progression over 3 years, whereas those with low stress had only slight progression. In women who were free of stress from either family or work life, i.e. they were satisfied with both of these life domains, the coronary artery changes had regressed. Their mean coronary luminal diameter increased by 0.22 mm (95% CI: 0.10; 0.35 mm) when compared with women who experienced stress from both sources, whose luminal diameter decreased by 0.20 mm (95% CI: -0.14; -0.25). These associations were independent of baseline luminal diameter and standard cardiovascular risk factors, including age smoking, hypertension and HDL at baseline.
  
  
  CONCLUSIONS
  Stress from family or work life may accelerate coronary disease processes in women, whereas relative protection may be obtained from a satisfactory job and a happy marriage.
authors.affiliation: Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: H-X
authors.initials: HX
authors.lastname: Wang
authors.forename: C
authors.initials: C
authors.lastname: Leineweber
authors.forename: R
authors.initials: R
authors.lastname: Kirkeeide
authors.forename: B
authors.initials: B
authors.lastname: Svane
authors.forename: K
authors.initials: K
authors.lastname: Schenck-Gustafsson
authors.forename: T
authors.initials: T
authors.lastname: Theorell
authors.forename: K
authors.initials: K
authors.lastname: Orth-Gomér
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000453:epidemiology / Q000523:psychology*; D003327:Coronary Disease / Q000453:epidemiology / Q000523:psychology*; D018450:Disease Progression; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009784:Occupational Diseases / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D017132:Workplace / Q000523:psychology