SDOH-Related Stress Can Lead to Increased Risk of Heart Disease

Stress due to social determinants of health can increase an individual’s risk of heart disease, according to the American Heart Association.

Studies have indicated that cumulative exposure to daily stressors or traumatic stress due to social determinants of health can increase cardiovascular disease risk. In addition, a growing body of research refers to the mind-heart-body connection, suggesting that a person’s mind can positively or negatively impact their cardiovascular well-being.

“The stress hormones norepinephrine, epinephrine, dopamine, and cortisol can increase with stress from life events, work, relationships, finances, and more. And we confirmed that stress is a key factor contributing to the risk of hypertension and cardiovascular events,” study author Kosuke Inoue, MD, PhD, said in a press release.

While previous research focused on the relationship between stress hormone levels and hypertension or cardiovascular events in patients with existing hypertension, Inoue explained that there is a lack of studies examining adults without hypertension.

“It is important to examine the impact of stress on adults in the general population because it provides new information about whether routine measurement of stress hormones needs to be considered to prevent hypertension and CVD events,” Inoue said.

The study subjects took part in the Multi-Ethnic Study of Atherosclerosis (MESA) Stress 1 study, examining atherosclerosis risk factors among more than 6,000 men and women from six communities in the United States.

Researchers analyzed levels of norepinephrine, epinephrine, dopamine, and cortisol through a 12-hour overnight urine test. Study participants were then followed for three more visits to watch for the development of hypertension and cardiovascular events.

Whereas norepinephrine, epinephrine, and dopamine are molecules that maintain stability throughout the autonomic nervous system, cortisol is a steroid hormone released when one experiences stress.

“Although all of these hormones are produced in the adrenal gland, they have different roles and mechanisms to influence the cardiovascular system, so it is important to study their relationship with hypertension and cardiovascular events, individually,” Inoue said. 

The study analysis indicated that in a median follow-up period of 6.5-years, every time the levels of the four stress hormones doubled, participants had a 21- 31 percent increased chance of developing hypertension. Additionally, in a median follow-up period of 11.2-years, there was a 90 percent increased risk of cardiovascular events each time cortisol levels doubled.

“It is challenging to study psychosocial stress since it is personal, and its impact varies for each individual. In this research, we used a noninvasive measure — a single urine test — to determine whether such stress might help identify people in need of additional screening to prevent hypertension and possibly cardiovascular events,” Inoue continued.

“The next key research question is whether and in which populations increased testing of stress hormones could be helpful. Currently, these hormones are measured only when hypertension with an underlying cause or other related diseases are suspected. However, if additional screening could help prevent hypertension and cardiovascular events, we may want to measure these hormone levels more frequently.”