Chronic psychological stress seems associated with elements of the metabolic syndrome in patients with ischaemic heart disease

Abstract

Background and objectives: Chronic psychological stress, the metabolic syndrome (MS) and ischaemic heart disease (IHD) seem closely connected. In this study, we evaluate the association between chronic stress and elements of MS in patients with stable IHD.

Design: Cross-sectional cohort study.

Methods: Three hundred and fifty patients with stable IHD were included. Chronic stress was evaluated by the two questionnaires, Major Depression Inventory (MDI) and the psychological wellbeing index WHO-5, as well as by Pressure Pain Sensitivity (PPS), a physiological measure of hyperalgesia at the sternum known to be associated to elements of the chronic stress syndrome. Elements of MS were evaluated by dual-energy X-ray absorptiometry, body weight, HOMA-IR and blood lipids.

Results: Depressive symptoms were associated with a high percentage of body fat (β = 0.179, p = .001), and high level of triglycerides (β = 0.150, p = .007). Low psychological wellbeing was associated with a high percentage of body fat (β = –0.165, p = .002) and low level of HDL cholesterol (β = 0.128, p = .024). Chronic stress measured by PPS was associated with a high percentage body fat (β = 0.327, p < .001), low body weight (β = –0.218, p < .001) and low HDL-cholesterol (β = –0.137, p = .013). Adjusting for several life style factors did not change these results.

Conclusions: In patients with stable IHD, different measures of chronic psychological stress seem associated with a high percentage of body fat and adverse blood lipids independent of several lifestyle factors.

Keywords:

• Metabolic syndrome
• ischaemic heart disease
• stress
• depression
• wellbeing
• cholesterol
• body fat

Acknowledgements

We thank the staff at Department of Cardiology, Gentofte Hospital, Denmark for providing us with their database on patients with cardiovascular disease that had been appointed to rehabilitation. We are thankful to the staff of the Metabolic Ward, Herlev Hospital, Denmark, for their contribution concerning practical issues.

Disclosure statement

SB invented the instrument used to measure PPS (Ullmeter, patent numbers: PA 2004-00349; PA 2004-00550) and is a shareholder of the firm that owns the PPS instrument (Ullcare A/S). To avoid bias, he was not involved in patient contact, the collection of data or the statistical analysis. NB, JK, PB, ÅH, FG and FJ declare no conflicts of interest.

Additional information

Funding

This work was supported by the Johan Schrøder’s Family and Business Foundation, the Lundbeck Foundation, Else and Mogens Wedell-Wedellsborg’s Foundation and Carpenter Sophus Jacobsen and Wife Astrid Jacobsen’s Foundation.