Perceived stress, common carotid intima media thickness and occupational status: The Paris Prospective Study III

• Published in: International journal of cardiology Vol. 221; pp. 1025 - 1030
• Main Authors: Wiernik, Emmanuel, Lemogne, Cédric, Thomas, Frédérique, Perier, Marie-Cécile, Guibout, Catherine, Nabi, Hermann, Laurent, Stéphane, Pannier, Bruno, Boutouyrie, Pierre, Jouven, Xavier, Empana, Jean-Philippe
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ireland Ltd 15.10.2016
• Subjects: Cardiovascular; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - psychology; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - pathology; Carotid intima-media thickness; Carotid Intima-Media Thickness - statistics & numerical data; Cross-Sectional Studies; Diagnostic Self Evaluation; Employment - psychology; Employment - statistics & numerical data; Epidemiology; Female; Humans; Male; Middle Aged; Occupational status; Paris - epidemiology; Prospective Studies; Psychological stress; Risk Factors; Social Perception; Stress, Psychological - epidemiology; Stress, Psychological - physiopathology; Unemployment; Psychological stress; blood pressure; cardiovascular disease; body mass index; Occupational status; Epidemiology; Unemployment; BP; Risk factors; CVD; IMT; intima-media thickness; Carotid intima-media thickness; PSS-4; 4-item Perceived Stress Scale; CCA-IMT; common carotid artery intima-media thickness; BMI
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2016.07.068

Abstract Background 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. Methods IMT was measured in the right common carotid artery (CCA-IMT) 1 cm 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. Results The study population included 5140 participants (3539 men) in the labor force aged 55.9 years 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. Conclusions 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.