title: Meta-analysis of perceived stress and its association with incident coronary heart disease.
abstract: Most studies examining potential associations between psychological factors and cardiovascular outcomes have focused on depression or anxiety. The effect of perceived stress on incident coronary heart disease (CHD) has yet to be reviewed systematically. We conducted a systematic review and meta-analysis of the association between perceived stress and incident CHD. Ovid, MEDLINE, and PsycINFO were searched as data sources. Prospective observational cohort studies were selected that measured self-reported perceived stress and assessed incident CHD at ≥6 months. We extracted study characteristics and estimates of the risk of incident CHD associated with high perceived stress versus low perceived stress. We identified 23 potentially relevant articles, of which 6 met our criteria (n = 118,696). Included studies measured perceived stress with validated measurements and nonvalidated simple self-report surveys. Incident CHD was defined as new diagnosis of, hospitalization for, or mortality secondary to CHD. Meta-analysis yielded an aggregate risk ratio of 1.27 (95% confidence interval 1.12 to 1.45) for the magnitude of the relation between high perceived stress and incident CHD. In conclusion, this meta-analysis suggests that high perceived stress is associated with a moderately increased risk of incident CHD.
authors.affiliation: College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA.
authors.forename: Safiya
authors.initials: S
authors.lastname: Richardson
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Shaffer
authors.forename: Louise
authors.initials: L
authors.lastname: Falzon
authors.forename: David
authors.initials: D
authors.lastname: Krupka
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.forename: Donald
authors.initials: D
authors.lastname: Edmondson
mesh_terms: D003327:Coronary Disease / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D010465:Perception; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*