Life Psychosocial Stresses and Coronary Artery Disease

Abstract

Background: It is hypothesized that the impacts of life events accumulate and can trigger and
promote atherosclerosis in susceptible individuals. In the current study, the correlation of total
life stressors during 1 year was investigated relative to coronary artery disease (CAD).

Methods: The study population consisted of 148 males and 152 females aged 35–76 years.
The subjects were classified as CAD cases and controls according to the results of coronary
angiography. The severity of CAD was scored on the basis of the number and the extent of lesions
at coronary arteries. The stressful events of life were assessed using Holmes‑Rahe Questionnaire
and was presented as total psychological stress scores per year (TPSS).

Results: The frequency of cigarette smoking, diabetes mellitus, and hypertension was more
prevalent in CAD cases than control subjects. The levels of TPSS were increased in patients
with CAD compared to the controls (160.3 ± 71.3 vs. 139.8 ± 66.5, P = 0.020). TPSS was also
associated positively with the levels of uric acid, erythrocytes counts, erythrocyte sedimentation
rate, aspirin consumption, and negatively with high‑density lipoprotein‑cholesterol and apo‑AI.
In logistic regression analysis, TPSS correlated with the occurrence of CAD by the odds ratio of
1.773 (1.073–2.930), P = 0.025, but the association was weakened after adjustment for classical
risk factors, especially hypertension. TPSS exhibited significant association with the severity of
CAD [F (3,274) = 2.6, P = 0.051].

Conclusions: The results suggest that TPSS are associated with the occurrence and severity
of CAD significantly, but the association is not independent.

Keywords: Coronary artery disease, life events, psychosocial, stress