title: Perceived stress, common carotid intima media thickness and occupational status: The Paris Prospective Study III.
abstract: BACKGROUND
  The association between psychological factors and cardiovascular diseases may depend upon socio-economic status. The present cross-sectional study examined the potential moderating role of occupational status on the association between perceived stress and intima-media thickness (IMT), using baseline examination data of the Paris Prospective Study III.
  
  
  METHODS
  IMT was measured in the right common carotid artery (CCA-IMT) 1cm below the bifurcation, in a zone free of discrete plaques, using non-invasive high-resolution echotracking. Perceived stress was measured with the 4-item Perceived Stress Scale. The association between perceived stress and CCA-IMT was explored using linear regression analysis and regression coefficients (b) were given per 1-point increment.
  
  
  RESULTS
  The study population included 5140 participants (3539 men) in the labor force aged 55.9years on average (standard deviation: 3.9), and who were free of personal history of cardiovascular disease and not on psychotropic drugs. There was a non-significant trend between perceived stress and CCA-IMT after adjustment for socio-demographic, self-rated health and cardiovascular risk factors (b [95% CI] 1.02 [-0.08;2.12]; p=0.069). However, multivariable stratified analysis indicates a significant and robust association between perceived stress and CCA-IMT in unemployed participants (b [95% CI] 3.30 [0.44;6.17]), and an association of same magnitude in working participants with low occupational status but without reaching statistical significance.
  
  
  CONCLUSIONS
  The association between perceived stress and CCA-IMT may depend upon employment status. These results may explain why psychological stress is more tightly linked to cardiovascular disease among individuals facing social adversity.
authors.affiliation: Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Inserm, Villejuif, France. Electronic address: emmanuel.wiernik@inserm.fr.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Wiernik
authors.affiliation: AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie de l'adulte et du sujet âgé, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm U894, Centre Psychiatrie et Neurosciences, Paris, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Lemogne
authors.affiliation: Preventive and Clinical Investigation Centre, Paris, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Thomas
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm U970, Paris Cardiovascular Research Centre (PARCC), Cardiovascular epidemiology and Sudden Death Team, Paris, France.
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Perier
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm U970, Paris Cardiovascular Research Centre (PARCC), Cardiovascular epidemiology and Sudden Death Team, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Guibout
authors.affiliation: Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Inserm, Villejuif, France.
authors.forename: Hermann
authors.initials: H
authors.lastname: Nabi
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm U970, Paris Cardiovascular Research Centre (PARCC), Cardiovascular epidemiology and Sudden Death Team, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Pharmacology, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Laurent
authors.affiliation: Preventive and Clinical Investigation Centre, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pannier
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm U970, Paris Cardiovascular Research Centre (PARCC), Cardiovascular epidemiology and Sudden Death Team, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Pharmacology, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Boutouyrie
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm U970, Paris Cardiovascular Research Centre (PARCC), Cardiovascular epidemiology and Sudden Death Team, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Cardiology, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Jouven
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm U970, Paris Cardiovascular Research Centre (PARCC), Cardiovascular epidemiology and Sudden Death Team, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Empana
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012938:Social Perception; D013315:Stress, Psychological / Q000453:epidemiology / Q000503:physiopathology
keywords: Carotid intima-media thickness; Epidemiology; Occupational status; Psychological stress; Risk factors; Unemployment