Association Between Subjective Stress and Cardiovascular Diseases in Korean Population

Miae Doo; Yangha Kim

doi:10.12997/jla.2015.4.2.101

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Doo and Kim: Association Between Subjective Stress and Cardiovascular Diseases in Korean Population

Original Article

Journal of Lipid and Atherosclerosis 2015; 4(2): 101-108.

Published online: 31 December 2015

DOI: https://doi.org/10.12997/jla.2015.4.2.101

Association Between Subjective Stress and Cardiovascular Diseases in Korean Population

Miae Doo, Yangha Kim

Department of Nutritional Sciences and Food Management, Ewha Womans University, Seoul, Korea.

Corresponding Author: Yangha Kim. Department of Nutritional Sciences and Food Management, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-3101, Fax: +82-2-3277-4425, yhmoon@ewha.ac.kr

Received 8 May 2015 Revised 1 June 2015 Accepted 7 July 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Cardiovascular diseases, Psychological stress, Risk factor, Nutritional status

Figures and Tables

Fig. 1

Association between subjective stress level and prevalence of cardiovascular diseases. ORs (95% CI) were calculated in reference to low subjective stress level using multivariate logistic regression after adjustment for age (years) and gender (men, women) as non-modifiable risk factors (^*p<0.05, ^**<0.01).

Fig. 2

Adjusted odd ratios for prevalence of cardiovascular diseases (A) ORs (95% CI) were calculated in reference to low subjective stress level using multivariate logistic regression after adjustment for age (years), gender (men, women). (B) ORs (95% CI) were calculated in reference to low subjective stress level using multivariate logistic regression after adjustment for age (years), gender (men, women), education level (≤high school, ≥college), household income (low, high), occupation (administrator, professional and related worker, officer, service workers salesman, farmer and fisherman, technician and related worker), marital status (yes. no), physical activity (yes, no), smoking status (yes, no), body mass index (kg/m²), and energy intake (kcal) (^*p<0.05, ^**<0.01).

Fig. 3

Dietary intakes according to subjective stress level. Data were represented means±SD about representative of the entire Korean population. p-value was obtained using t-test (^*p<0.001).

Table 1

General characteristics according to subjective stress level

Data represented the means±SD or % about representative of Korean population.

^*p value was obtained using t-test or χ²-test.

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