Multiple stressors compound heart disease risk

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NEW YORK, Nov 17 (Reuters) The more psychosocial stressors a person faces in daily life, the greater their heart disease risk is, and the relationship is particularly strong for women, a new study shows.

Women were also more likely to report a higher number of such stressors, Dr Rebecca C Thurston of the University of Pittsburgh School of Medicine and Dr Laura D Kubzansky of the Harvard School of Public Health in Boston found. ''Women more often experienced these clustered risk factors as opposed to men,'' Thurston told Reuters Health.

She and Kubzansky also found that the gender difference in the stress-health relationship they observed appeared to be because women with more psychosocial risk factors were also more likely to be obese.

''As a woman the more psychosocial risk factors you have the more likely you are to be obese and this in turn increases your risk of heart disease,'' Thurston explained. ''For the men in this study, psychosocial risk was not really associated with obesity.'' Most studies have looked at the health effects of psychosocial disadvantages such as poverty, depression and single parenthood separately, the researchers note in their report in the journal Psychosomatic Medicine. Because people may have one or more of these stressors in their lives, the researchers looked at the effect of several together, including unemployment, divorce, death of a spouse, and high anxiety levels.

They evaluated these indicators of psychosocial disadvantage in 6,913 men and women who were followed for more than 22 years.

Having one indicator increased the likelihood of being diagnosed with heart disease during the course of the study by 28 per cent, while having two or three boosted risk by 56 per cent. Individuals with four or more indicators of psychosocial disadvantage were 2.63 times as likely as those with no similar stressors to develop heart disease.

The risk rose with the number of disadvantage indicators, regardless of which ones were involved. The effect of psychological disadvantage on heart health was stronger for women, who were also more likely than men to be coping with several psychosocial stressors at once.

''At least in reality, people don't have one stressor at a time, these things tend to cluster,'' says Thurston, who points out that while researchers have looked at the cumulative effects of biomedical risk factors such as high blood pressure and diabetes, there has been little study of how psychological and social disadvantages interact on heart disease risk.

''These multiple forms of disadvantage may together comprise a type of 'psychosocial risk syndrome,' akin to a metabolic syndrome, in which high scores may place an individual at high risk for disease,'' she and Kubzansky write. Preventive health efforts should take societal inequalities that lead to such disadvantages into account, they conclude.


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