Psychosocial stress and atherosclerosis: family and work stress accelerate progression of coronary disease in women. The Stockholm Female Coronary Angiography Study

• Published in: Journal of internal medicine Vol. 261; no. 3; pp. 245 - 254
• Main Authors: Wang, H.‐X., Leineweber, C., Kirkeeide, R., Svane, B., Schenck‐Gustafsson, K., Theorell, T., Orth‐Gomér, K.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2007; Blackwell Science
• Subjects: Adult; Aged; Analysis of Variance; atherosclerosis; Atherosclerosis - epidemiology; Atherosclerosis - psychology; Biological and medical sciences; Coronary Disease - epidemiology; Coronary Disease - psychology; Disease Progression; Family - psychology; Female; General aspects; Humans; job stress; Longitudinal Studies; marital stress; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Miscellaneous; Occupational Diseases - complications; Occupational Diseases - epidemiology; progression; psychosocial factors; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Stress, Psychological - complications; Stress, Psychological - epidemiology; Sweden - epidemiology; Workplace - psychology; Sweden; Europe; Human; Prognosis; Radiodiagnosis; Family study; Cardiovascular disease; progression; Coronary arteriography; Psychosocial factor; Coronary heart disease; Stress; marital stress; Vascular disease; Medicine; job stress; psychosocial factors; Atherosclerosis; Family environment; Work; Adult; Evolution; Female; Woman; Social aspect; Public health
• ISSN: 0954-6820; 1365-2796
• DOI: 10.1111/j.1365-2796.2006.01759.x

. Objective.  To examine the impact of psychosocial stress, experienced in the family and work life, on the progression of coronary atherosclerosis in women cardiac patients. Design.  Longitudinal follow‐up study. The mean luminal diameter change over 3 years was averaged over 10 predefined coronary segments, representing the entire coronary tree. Stress in family life was measured by using the Stockholm Marital Stress Scale and that of work life by the demand‐control questionnaire. Subjects.  Amongst patients enrolled in the Stockholm Female Coronary Angiography Study, 80 women were evaluated for stress exposure and coronary atherosclerosis progression using serial quantitative coronary angiography. Results.  Multi‐variable‐controlled mixed models anova analyses revealed that women with high stress from either family or work had significant disease progression over 3 years, whereas those with low stress had only slight progression. In women who were free of stress from either family or work life, i.e. they were satisfied with both of these life domains, the coronary artery changes had regressed. Their mean coronary luminal diameter increased by 0.22 mm (95% CI: 0.10; 0.35 mm) when compared with women who experienced stress from both sources, whose luminal diameter decreased by 0.20 mm (95% CI: −0.14; −0.25). These associations were independent of baseline luminal diameter and standard cardiovascular risk factors, including age smoking, hypertension and HDL at baseline. Conclusions.  Stress from family or work life may accelerate coronary disease processes in women, whereas relative protection may be obtained from a satisfactory job and a happy marriage.