Interactions of chronic stress exposure and stress appraisal on vascular endothelial function among young adults

We investigated the associations of ongoing, chronic stress exposure and stress appraisal on vascular endothelial function (VEF) in young adults. In 72 healthy young adults (74% female; age = 25 ± 1 yr), we assessed chronic stress exposure and appraisal with a measure that quantified chronic stress exposure and chronic stress appraisal related to eight specific stressors over the last year. Participants completed the perceived stress scale (PSS) as a measure of global, proximal stress appraisal. VEF was assessed using the brachial artery flow-mediated dilation technique. We examined relations among ongoing, chronic stress exposure and stress appraisal versus VEF adjusted for age and sex, and then assessed whether stress appraisal moderated the effect of chronic stress exposure on VEF. Chronic stress exposure (β = -0.24, P = 0.045), but not chronic stress appraisal (β = 0.07, P = 0.56) or perceived stress (β = -0.20, P = 0.11), was related to VEF. Perceived stress (P = 0.046), but not chronic stress appraisal (P = 0.54), moderated the association between chronic stress exposure and VEF. The effect of chronic stress exposure on VEF ceased to be significant at a PSS score of ∼22. Subsequent exploratory stratified analysis indicated that those with PSS ≥22 had increased exposure to adverse childhood experiences (+1.6 ± 0.6, P = 0.01), greater depressive symptoms (+10.2 ± 2.7, P < 0.001), and reduced psychological resilience (-7.6 ± 3.5, P = 0.036). Chronic stress exposure significantly predicts impaired VEF among young adults. Furthermore, this relation is influenced by proximal perceived stress, such that the association of chronic stress exposure on VEF may be obscured at high levels of proximal perceived stress.NEW & NOTEWORTHY Our findings indicate that ongoing chronic stress exposure over the last year is significantly associated with reduced vascular endothelial function among apparently healthy young adults. Our data provide important insights into the interplay of chronic stress exposure versus proximal perceived stress and may also support the hypothesis that young adults who are sensitized to stress may be particularly vulnerable to stress-related impairments in vascular endothelial function.