Department of Family Medicine, Medical University of South Carolina, Charleston SC 29425, USA.
Int J Psychiatry Med. 2010;40(2):147-61. doi: 10.2190/PM.40.2.b.
To examine the relationship between a general measure of chronic life stress and atherosclerosis among middle aged adults without clinical cardiovascular disease via pathways through unhealthy lifestyle characteristics.
We conducted an analysis of The Multi-Ethnic Study of Atherosclerosis (MESA). The MESA collected in 2000 includes 5,773 participants, aged 45-84. We computed standard regression techniques to examine the relationship between life stress and atherosclerosis as well as path analysis with hypothesized paths from stress to atherosclerosis through unhealthy lifestyle. Our outcome was sub-clinical atherosclerosis measured as presence of coronary artery calcification (CAC).
A logistic regression adjusted for potential confounding variables along with the unhealthy lifestyle characteristics of smoking, excessive alcohol use, high caloric intake, sedentary lifestyle, and obesity yielded no significant relationship between chronic life stress (OR 0.93, 95% CI 0.80-1.08) and CAC. However, significant indirect pathways between chronic life stress and CAC through smoking (p = .007), and sedentary lifestyle (p = .03) and caloric intake (.002) through obesity were found.
These results suggest that life stress is related to atherosclerosis once paths of unhealthy coping behaviors are considered.
通过不健康的生活方式特征的途径，研究中年人群中普遍存在的慢性生活压力与动脉粥样硬化之间的关系，这些人群没有临床心血管疾病。
我们对动脉粥样硬化多民族研究（MESA）进行了分析。MESA 于 2000 年开始收集数据，共包括 5773 名年龄在 45-84 岁的参与者。我们采用标准回归技术来检查生活压力与动脉粥样硬化之间的关系，以及通过不健康的生活方式来分析从压力到动脉粥样硬化的假设路径。我们的结果是作为冠状动脉钙化（CAC）存在的亚临床动脉粥样硬化的指标。
在调整了潜在混杂变量以及吸烟、过量饮酒、高热量摄入、久坐不动的生活方式和肥胖等不健康的生活方式特征后，慢性生活压力（OR 0.93，95%CI 0.80-1.08）与 CAC 之间没有显著的相关性。然而，通过吸烟（p=0.007）和久坐的生活方式（p=0.03）以及肥胖通过热量摄入（p=0.002），发现了慢性生活压力与 CAC 之间存在显著的间接途径。
这些结果表明，一旦考虑到不健康的应对行为途径，生活压力与动脉粥样硬化有关。
