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High-perceived stress associates with a moderately increased risk of incident coronary heart disease. Donald Edmondson, from Columbia University (New York, USA), and colleagues assessed the effect of perceived stress on incident coronary heart disease.

The team completed a meta-analysis of six observational cohort studies involving a total of 118,696 participants, with mean ages ranging from 44 to 73 years and average follow-up of 13.8 years, that included self-reported measurements of perceived stress and assessments of incident coronary heart disease events—including related diagnoses, hospitalizations, and deaths—at six months or later. Three of the six studies identified a significant association between high-perceived stress and a greater risk of receiving a coronary heart disease diagnosis. Two other studies—one looking at coronary heart disease death and the other looking at diagnosis—revealed nonsignificant trends in the same direction. The final study, which evaluated hospitalization for coronary heart disease, reported a risk ratio of 1.00. Pooling all of the studies together yielded a significant relationship between high-perceived stress and incident coronary heart disease. The study authors conclude that: “This meta-analysis suggests that high perceived stress is associated with a moderately increased risk of incident [coronary heart disease].”


  1. Richardson S, Shaffer JA, Falzon L, Krupka D, Davidson KW, Edmondson D. “Meta-analysis of perceived stress and its association with incident coronary heart disease.” Am J Cardiol. 2012 Dec 15;110(12).