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Association of Perceived Stress With Incident Heart Failure
Lauren Balkan1, Joanna B Ringel1, Emily B Levitan2
1Department of Medicine, Weill Cornell Medicine, New York, New York.
Journal of Cardiac Failure
|May 14, 2022
Summary
High perceived stress is linked to developing heart failure with preserved ejection fraction, but not heart failure with reduced ejection fraction. This finding highlights the impact of psychological stress on specific heart failure types.
Area of Science:
- Cardiology
- Psychology
- Public Health
Background:
- The link between psychological stress and heart failure (HF) requires further investigation.
- Previous research has not adequately explored the association between perceived stress and incident HF.
Purpose of the Study:
- To examine the relationship between perceived stress and the occurrence of incident heart failure.
- To differentiate the association of perceived stress with HF subtypes: HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF).
Main Methods:
- Utilized data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a prospective biracial cohort.
- Included 25,785 participants (aged ≥45) free of prevalent HF, assessing perceived stress using the Perceived Stress Scale (PSS-4).
- Employed Cox proportional hazard models to analyze associations between PSS-4 quartiles and incident HF events, adjusting for multiple covariates and testing for interactions with statin use.
Main Results:
- Among 25,785 participants followed for a median of 10.1 years, 1109 incident HF events occurred.
- Elevated perceived stress (higher PSS-4 quartiles) was significantly associated with increased risk of incident HFpEF.
- No significant association was found between perceived stress and incident HF or HFrEF. The HFpEF association was attenuated by baseline statin use.
Conclusions:
- Elevated perceived stress is independently associated with an increased risk of developing HFpEF.
- Perceived stress does not appear to be a significant risk factor for incident HFrEF.
- Findings suggest stress management may be important for preventing specific types of heart failure.
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