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Stress From Adolescence to Adulthood Linked to Higher Cardiometabolic Risk in Young Adulthood

Increased perceived stress in adolescence to adulthood increases cardiometabolic risk in adulthood.

Individuals who have consistently increased levels of perceived stress from adolescence to adulthood have a higher cardiometabolic risk compared with those with other stress patterns, according to a study in the Journal of the American Heart Association.

Researchers assessed associations between perceived stress in childhood, adolescence, and adulthood and 7 markers of cardiometabolic risk in adulthood and whether patterns of perceived stress from adolescence to adulthood predict cardiometabolic risk in adulthood.

Data were obtained from the Southern California Children’s Health Study (CHS). Participants from cohort E of the CHS were recruited in 2003 (mean age, 6.3 years), and followed up every 1 to 2 years through the end of high school, and questionnaires were completed by parents and by the children themselves after age 12 years.

A substudy on cardiovascular health was conducted in a subset of CHS cohort E participants (n=737) from 8 southern California communities in 2008. These participants were invited to participate in a follow-up cardiovascular assessment in 2018.

Our findings suggest that promoting healthy coping strategies for stress management early in life (eg, adolescence) may facilitate the prevention of cardiometabolic diseases.

A cumulative cardiometabolic risk score was calculated based on 5 markers. Multivariable linear or logistic regression models included 3 measures of perceived stress in the same model and assessed their associations with each of the 7 cardiometabolic outcomes and the cumulative risk score.

The analysis included 276 individuals (55.8% women; 62.0% White). Their mean age was 6.3±0.6 years in childhood, 13.3±0.6 years in adolescence, and 23.6±1.6 years in adulthood. Parent-perceived stress based on participants’ childhood (mean, 3.9) was lower vs participants’ Perceived Stress Scale (PSS) score in adolescence (P <.001) and adulthood (P <.001). Adult PSS had a significant association with adolescent PSS, but not with childhood PSS perceived by parents.

Individuals who had a greater PSS score had significantly greater carotid artery intima-media thickness (β, 0.01; 95% CI, 0.0003-0.02; P =.043), diastolic blood pressure (β, 0.94; 95% CI, 0.13-1.75; P =.024), and systolic blood pressure (β, 1.27; 95% CI, 0.09-2.45; =.035) in adulthood.

PSS scores in adulthood had a significant overall association with the cumulative cardiometabolic risk score (β, 0.12; 95% CI, 0.01-0.22; P =.031), and PSS scores in childhood and adolescence were not significantly associated with this cumulative score.

Models that predicted cardiometabolic risk by perceived stress patterns indicated that individuals who had consistently high PSS from adolescence to young adulthood had significantly increased cumulative cardiometabolic risk scores (β, 0.31; 95% CI, 0.02-0.60; P =.036), android/gyroid ratio (β, 0.07; 95% CI, 0.02-0.13; P =.009), and percent body fat (β, 2.59; 95% CI, 0.01-5.17; P =.049), as well as greater odds for obesity (odds ratio [OR], 5.57; 95% CI, 1.62-19.10; P =.006), compared with individuals who had consistently low PSS scores.

Participants who had decreasing PSS scores over time also had significantly higher odds for obesity (OR, 4.87; 95% CI, 1.30-18.34; P =.019) compared with those who had consistently low PSS.

Among several limitations, the population was young adults primarily living in southern California, and parent-perceived stress in young childhood likely reflects the children’s social environment at home, which may not represent the children’s stress level. In addition, the analysis may not fully adjust for time-varying covariates, and the cardiometabolic cumulative risk score assumed that each indicator has equal weight toward the cardiometabolic risk.

“Our findings suggest that promoting healthy coping strategies for stress management early in life (eg, adolescence) may facilitate the prevention of cardiometabolic diseases,” the study authors wrote.


Photo by cottonbro studio

By Colby Stong

This article originally appeared on The Cardiology Advisor


Guo F, Chen X, Howland S, et al. Perceived stress from childhood to adulthood and cardiometabolic end points in young adulthood: an 18-year prospective studyJ Am Heart Assoc. Published online January 17, 2024. doi: 10.1161/JAHA.123.030741