Perceived stress as a risk factor for changes in health behaviour and cardiac risk profile: a longitudinal study.
OBJECTIVE
The aim of this study was to evaluate the long-term effects of stress on changes in health behaviour and cardiac risk profile in men and women.


METHODS
A prospective cohort study.


METHODS
The Copenhagen City Heart Study, Denmark.


METHODS
The analyses were based on 7066 women and men from the second (1981-1983) and third (1991-1993) wave of the Copenhagen City Heart Study. All participants were asked questions on stress and health behaviour and they had their weight, height, blood pressure and level of blood lipids measured by trained personnel.


METHODS
Changes in health behaviour (smoking, physical activity, alcohol consumption, overweight) and cardiac risk profile (cholesterol, HDL cholesterol, blood pressure, diabetes).


RESULTS
Individuals with high levels of stress compared to those with low levels of stress were less likely to quit smoking (OR = 0.58; 95% CI: 0.41-0.83), more likely to become physically inactive (1.90; 1.41-2.55), less likely to stop drinking above the sensible drinking limits (0.43; 0.24-0.79), and stressed women were more likely to become overweight (1.55; 1.12-2.15) during follow-up. Men and women with high stress were more likely to use antihypertensive medication (1.94; 1.63-2.30), and stressed men were more than two times as likely to develop diabetes during follow-up (2.36; 1.22-4.59).


CONCLUSIONS
This longitudinal study supports a causal relation between stress and cardiovascular diseases mediated through unfavourable changes in health behaviour and cardiac risk profile.
Rod
Naja Hulvej
NH
Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark. n.rod@pubhealth.ku.dk
Grønbaek
M
M
Schnohr
P
P
Prescott
E
E
Kristensen
T S
TS
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001794:Blood Pressure; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000097:blood / Q000523:psychology*; D002784:Cholesterol / Q000097:blood; D003718:Denmark / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012907:Smoking / Q000453:epidemiology; D013315:Stress, Psychological / Q000097:blood / Q000523:psychology*; D011795:Surveys and Questionnaires
D002784:Cholesterol