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High Perceived Stress Predicts Worse Clinical Outcomes in Patients with Stable Coronary Heart Disease

Yifan Gao1,2,3, Yanming Chen1, Rong Hu2

  • 1Department of Cardiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.

Depression and Anxiety
|April 14, 2025
PubMed

Insights

High perceived stress (HPS) in stable coronary heart disease (CHD) patients predicts cardiovascular events within 24 months. Addressing HPS in CHD patients may improve prognosis and reduce adverse cardiovascular events.

Area of Science:

  • Cardiology
  • Psychosomatic Medicine
  • Public Health

Background:

  • High stress is linked to coronary heart disease (CHD).
  • The prognostic impact of perceived stress in stable CHD patients is not well understood.
  • This study examines high perceived stress (HPS) and cardiovascular events in stable CHD.

Purpose of the Study:

  • To investigate the association between high perceived stress (HPS) and cardiovascular events in patients with stable coronary heart disease (CHD).
  • To determine if HPS is an independent predictor of adverse cardiovascular outcomes in this population.

Main Methods:

  • 2215 stable CHD patients were recruited between March 2015 and December 2020.
  • Perceived stress was assessed using the Chinese Perceived Stress Scale-14 (CPSS).
  • Kaplan-Meier curves and log-rank tests analyzed cardiovascular event rates, adjusting for covariates.

Main Results:

  • Patients with HPS (CPSS ≥ 31) had a higher incidence of cardiovascular events (18.7%) compared to non-HPS patients (14.1%).
  • HPS was associated with a significantly increased risk of cardiovascular events within 24 months (HR 1.369, P=0.027) after adjustment.
  • The impact of HPS on event risk diminished after 24 months.

Conclusions:

  • High perceived stress is a significant predictor of cardiovascular events in stable CHD patients within the first 24 months.
  • Clinical attention to HPS in stable CHD patients is warranted to potentially improve prognosis.
  • Targeting psychological stress may be a valuable strategy in managing stable coronary heart disease.
Abstract

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