J Lipid Atheroscler.  2015 Dec;4(2):101-108. 10.12997/jla.2015.4.2.101.

Association Between Subjective Stress and Cardiovascular Diseases in Korean Population

Affiliations
  • 1Department of Nutritional Sciences and Food Management, Ewha Womans University, Seoul, Korea. yhmoon@ewha.ac.kr

Abstract


OBJECTIVES
The purpose of this study was to investigate the effects of subjective stress levels on various characteristics, dietary intake, and cardiovascular disease (CVD) among Korean people. METHOD: This study conducted analyses on subjective stress levels and demographic-, socioeconomic-, health-related factors, dietary intake and CVD of 15,474 subjects aged over 20 years from the 5th Korean National Health and Nutrition Examination Survey database. In addition, the presence of CVD including angina, myocardial infarction, and stroke was analyzed.
RESULTS
The responses of 25.6% of the subjects were that they felt high levels of stress. Significant differences in age, gender, education level, occupation, marital status, smoking and drinking status were observed by subjective stress levels (p<0.001 for all except p=0.035 for drinking status). After adjustment for non-modifiable covariates and modifiable covariates, subjects with high levels of stress showed an increase in the risk of angina, myocardial infarction-angina, and CVD, compared to those with low levels of stress [OR (95% CI) for non-modifiable covariates: 1.41 (1.04-1.90, p<0.05), 1.36 (1.06-174, p<0.05), and 1.30 (1.07-1.58, p<0.001)] and [OR (95% CI) for modifiable covariates: 1.44 (1.05-1.97, p<0.05), 1.41 (1.09-1.83, p<0.001), and 1.37 (1.12-1.68, p<0.001)]. Also, subjects with high levels of stress consumed more dietary fat than those with low levels of stress, but the opposite trend was observed regarding the consumption of carbohydrates (p<0.001 for both).
CONCLUSION
Our findings showed that subjective stress levels adjusted for modifiable risk factors induced increased occurrence of CVD than that adjusted for non-modifiable risk factors.

Keyword

Cardiovascular diseases; Psychological stress; Risk factor; Nutritional status

MeSH Terms

Carbohydrates
Cardiovascular Diseases*
Dietary Fats
Drinking
Education
Marital Status
Myocardial Infarction
Nutrition Surveys
Nutritional Status
Occupations
Risk Factors
Smoke
Smoking
Stress, Psychological
Stroke
Carbohydrates
Dietary Fats
Smoke

Figure

  • Fig. 1 Association between subjective stress level and prevalence of cardiovascular diseases. ORs (95% CI) were calculated in reference to low subjective stress level using multivariate logistic regression after adjustment for age (years) and gender (men, women) as non-modifiable risk factors (*p<0.05, **<0.01).

  • Fig. 2 Adjusted odd ratios for prevalence of cardiovascular diseases (A) ORs (95% CI) were calculated in reference to low subjective stress level using multivariate logistic regression after adjustment for age (years), gender (men, women). (B) ORs (95% CI) were calculated in reference to low subjective stress level using multivariate logistic regression after adjustment for age (years), gender (men, women), education level (≤high school, ≥college), household income (low, high), occupation (administrator, professional and related worker, officer, service workers salesman, farmer and fisherman, technician and related worker), marital status (yes. no), physical activity (yes, no), smoking status (yes, no), body mass index (kg/m2), and energy intake (kcal) (*p<0.05, **<0.01).

  • Fig. 3 Dietary intakes according to subjective stress level. Data were represented means±SD about representative of the entire Korean population. p-value was obtained using t-test (*p<0.001).


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