Association Between Subjective Stress and Cardiovascular Diseases in Korean Population

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.