title: Chronic Stress and Endothelial Dysfunction: The Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: BACKGROUND
  Endothelial dysfunction may represent an important link between chronic stress and cardiovascular disease (CVD) risk. However, few studies have examined the impact of chronic stress on endothelial dysfunction. The purpose of this study was to examine whether chronic stress was associated with flow-mediated dilation (FMD) and 2 biomarkers of endothelial dysfunction (intercellular adhesion molecule-1 (ICAM-1) and E-selectin) in a multiethnic sample of adults (ages 45-84 years).
  
  
  METHODS
  Data come from the baseline examination of Multi-Ethnic Study of Atherosclerosis participants. Chronic stress was assessed based on self-report of the presence and severity of ongoing problems in 5 domains. FMD was obtained using high-resolution ultrasound; biomarkers were assayed in different subsets of participants.
  
  
  RESULTS
  Higher chronic stress was associated with lower absolute FMD (mm FMD) in models adjusted for demographic and socioeconomic characteristics (0.169mm in high-stress participants vs. 0.178 and 0.179mm in medium and low-stress participants; P for trend = 0.04). This association remained unchanged with further adjustment for behavioral and biological CVD risk factors. Higher stress was related to higher ICAM-1 in models adjusted for sociodemographic characteristics and biological risk factors (P for trend = 0.005), but this association attenuated with adjustment for cigarette smoking (P for trend = 0.07). Chronic stress was not associated with E-selectin.
  
  
  CONCLUSIONS
  Our findings suggest chronic stress is related to endothelial dysfunction, possibly in part through other stress-associated CVD risk factors such as cigarette smoking.
authors: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; k-kershaw@northwestern.edu.
authors: Kiarri N
authors: KN
authors: Kershaw
authors: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors: Abbi D
authors: AD
authors: Lane-Cordova
authors: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors: Mercedes R
authors: MR
authors: Carnethon
authors: Vanderbilt Center for Tobacco, Addictions, and Lifestyle, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors: Hilary A
authors: HA
authors: Tindle
authors: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors: Kiang
authors: K
authors: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D019040:E-Selectin; D018799:Intercellular Adhesion Molecule-1
keywords: E-selectin; ICAM-1.; blood pressure; chronic stress; endothelial dysfunction; flow-mediated dilation; hypertension