Wiernik Emmanuel, Lemogne Cédric, Thomas Frédérique, Perier Marie-Cécile, Guibout Catherine, Nabi Hermann, Laurent Stéphane, Pannier Bruno, Boutouyrie Pierre, Jouven Xavier, Empana Jean-Philippe
Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Inserm, Villejuif, France.
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.
Int J Cardiol. 2016 Oct 15;221:1025-30. doi: 10.1016/j.ijcard.2016.07.068. Epub 2016 Jul 5.
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.
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.
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.
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.
心理因素与心血管疾病之间的关联可能取决于社会经济地位。本横断面研究利用巴黎前瞻性研究III的基线检查数据，探讨了职业状况对感知压力与内膜中层厚度（IMT）之间关联的潜在调节作用。
使用无创高分辨率超声跟踪技术，在距分叉处下方1厘米的右侧颈总动脉（CCA-IMT）中无离散斑块的区域测量IMT。使用4项感知压力量表测量感知压力。采用线性回归分析探讨感知压力与CCA-IMT之间的关联，并给出每增加1分的回归系数（b）。
研究人群包括5140名劳动力参与者（3539名男性），平均年龄55.9岁（标准差：3.9），无心血管疾病个人史且未服用精神药物。在调整社会人口统计学、自我评估健康状况和心血管危险因素后，感知压力与CCA-IMT之间存在无统计学意义的趋势（b [95%CI] 1.02 [-0.08；2.12]；p = 0.069）。然而，多变量分层分析表明，失业参与者中感知压力与CCA-IMT之间存在显著且稳健的关联（b [95%CI] 3.30 [0.44；6.17]），职业地位低的在职参与者中也存在相同程度的关联，但未达到统计学意义。
感知压力与CCA-IMT之间的关联可能取决于就业状况。这些结果可能解释了为什么在面临社会逆境的个体中，心理压力与心血管疾病的联系更为紧密。
