Chronic financial stress and cardiovascular disease risk: A prospective cohort study and Mendelian randomization

Lu Ma1, Meng Lv2, Ying Li3

  • 1School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China.

Atherosclerosis
|July 31, 2025
PubMed

Insights

Financial difficulties causing chronic stress significantly increase cardiovascular disease (CVD) risk. This risk is partly mediated by body composition, lifestyle, immunity, and metabolism changes.

Area of Science:

  • Cardiovascular Science
  • Psychosomatic Medicine
  • Public Health

Background:

  • Chronic stress is a known risk factor for cardiovascular diseases (CVDs), but the underlying mechanisms are not fully understood.
  • This study investigates the association between chronic stress and incident CVDs, exploring potential mediating factors.

Purpose of the Study:

  • To examine the relationship between chronic stress and the risk of developing CVDs.
  • To identify and quantify the roles of metabolism, body composition, immunity, lifestyle, and cognitive function as mediators in this association.

Main Methods:

  • Analysis of 399,998 UK Biobank participants without pre-existing CVDs.
  • Utilized multivariable Cox proportional hazards models and two-sample Mendelian randomization (MR).
  • Assessed mediators including body composition (waist-to-height ratio, hip-to-height ratio), lifestyle factors (smoking, sedentary behavior, sleep, diet), immunity markers (lymphocyte count, CRP), and metabolism (HbA1c).

Main Results:

  • Chronic stress, particularly from financial difficulties, was linked to increased CVD risk.
  • Financial difficulties-related chronic stress showed significant associations with stroke, coronary heart disease, myocardial infarction, and heart failure.
  • Body composition (especially waist-to-height ratio), lifestyle, immunity, and metabolism collectively mediated 19.30%-34.40% of the effects of financial stress on CVDs.

Conclusions:

  • Chronic stress stemming from financial difficulties is a significant risk factor for incident cardiovascular diseases.
  • Body composition, lifestyle, immunity, and metabolism are key mediating pathways through which financial stress elevates CVD risk.
Abstract

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