The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
Meta-Analysis of Perceived Stress and Its Association With Incident Coronary Heart Disease
Open accessAbstract
Most studies examining potential associations between psychological factors and cardiovascular outcomes have focused on either depression or anxiety. The effect of perceived stress on incident coronary heart disease (CHD) has yet to be reviewed systematically. We conducted a systematic review and meta-analysis of the association between perceived stress and incident CHD. Ovid MEDLINE and PsycINFO were searched as data sources. Prospective observational cohort studies were selected that measured self-reported perceived stress and assessed incident CHD at minimum of 6 months later. We extracted study characteristics and estimates of the risk of incident CHD associated with high perceived stress vs. low perceived stress. We identified 23 potentially relevant articles, of which 6 met our criteria (N = 118,696). Included studies measured perceived stress with both validated measures and non-validated simple self-report surveys. Incident CHD was defined as new diagnosis of, hospitalization for, or mortality secondary to CHD. Meta-analysis yielded an aggregate risk ratio of 1.27 (95% confidence interval 1.12 – 1.45) for the magnitude of the relation between high perceived stress and incident CHD. In conclusion this meta-analysis suggests that high perceived stress is associated with a moderately increased risk of incident CHD.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“Another meta-analysis that focused on patient reports of perceived stress, regardless of cause, and included data from 118 696 participants across 6 studies found that high perceived stress was associated with a 27% increased risk in incident coronary heart disease (CHD) and CHD mortality (RR, 1.27 [95% CI, 1.12-1.45]). 19”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [19]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Small clinical trials evaluating a gratitude intervention (eg, gratitude journaling) suggested improvements in blood pressure, sleep, inflammatory biomarkers, and heart rate variability. 19,20”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [19]
Experimental — accuracy not yet measuredIn the citing paper
“Occupational stress has shown to be a major risk factor for a range of health outcomes, such as depression [1], coronary disease ( [2] and related mortality [3].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807
Chobanian, A. V. (2003) · JAMA · doi:10.1001/jama.289.19.2560 · Cited by 25,386
Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., Jones, D. W., Materson, B. J., Oparil, S., Wright, J. T., et al. (2003) · Hypertension · doi:10.1161/01.hyp.0000107251.49515.c2 · Cited by 13,271
(1988) · Cited by 4,111
Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress
Tsigos, C., & Chrousos, G. P. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00429-4 · Cited by 2,822 · cited 1×
“Possibilities include increased activity of the hypothalamic pituitary axis[23], increased sympathetic outflow[24] or altered behaviors causing insulin resistance and central obesity[25].”
A Fail-Safe N for Effect Size in Meta-Analysis
Orwin, R. G. (1983) · Journal of Educational Statistics · doi:10.2307/1164923 · Cited by 2,064 · cited 1×
“[8]”
Teo, K. K., Ôunpuu, S., Hawken, S., Pandey, M., Valentín, V., Hunt, D. U., Díaz, R., Rashed, W. A., Freeman, R. V., Jiang, L., et al. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69249-0 · Cited by 999
The Interpretation of Random-Effects Meta-Analysis in Decision Models
Ades, A. E., Lu, G., & Higgins, J. P. T. (2005) · Medical Decision Making · doi:10.1177/0272989x05282643 · Cited by 862
A Path Model of Chronic Stress, the Metabolic Syndrome, and Coronary Heart Disease
Vitaliano, P. P., Scanlan, J. M., Zhang, J., Savage, M. V., Hirsch, I. B., & Siegler, I. C. (2002) · Psychosomatic Medicine · doi:10.1097/00006842-200205000-00006 · Cited by 481 · cited 1×
“Measures of stress in recent studies have been heterogeneous and included disparate definitions such as caring for a demented partner or spouse[1], reporting of lack of general psychological well-being[2], or reporting the occurrence of negative life events like divorce[3].”
Fleiss, J. L., & Gross, A. J. (1991) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(91)90261-7 · Cited by 401
Work-Related Psychosocial Factors and the Development of Ischemic Heart Disease: A Systematic Review
Eller, N. H., Netterstrøm, B., Gyntelberg, F., Kristensen, T. S., Nielsen, F., Steptoe, A., & Theorell, T. (2009) · Cardiology in Review · doi:10.1097/crd.0b013e318198c8e9 · Cited by 323
Cardiovascular Responses to Behvioral Stress and Hypertension: A Meta-Analytic Review
Fredrikson, M., & Matthews, K. A. (1990) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm1201_3 · Cited by 305
Perceived Mental Stress and Mortality From Cardiovascular Disease Among Japanese Men and Women
Iso, H., Date, C., Yamamoto, A., Toyoshima, H., Tanabe, N., Kikuchi, S., Kondo, T., Watanabe, Y., Wada, Y., Ishibashi, T., et al. (2002) · Circulation · doi:10.1161/01.cir.0000028145.58654.41 · Cited by 288
Psychological treatment of cardiac patients: a meta-analysis
Linden, W., Phillips, M. J., & Leclerc, J. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm504 · Cited by 284
Gavaghan, D. J., Moore, A. R., & McQuay, H. J. (2000) · Pain · doi:10.1016/s0304-3959(99)00302-4 · Cited by 276
Eaker, E. D., Sullivan, L. M., Kelly-Hayes, M., D’Agostino, R. B., & Benjamin, E. J. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3180f62357 · Cited by 244 · cited 1×
“Types of chronic stress that have consistently been associated with increased cardiovascular risk are work-related stress[4] and marital stress[5].”
Self-perceived psychological stress and incidence of coronary artery disease in middle-aged men
Rosengren, A., Tibblin, G., & Wilhelmsen, L. (1991) · The American Journal of Cardiology · doi:10.1016/0002-9149(91)90189-r · Cited by 193
Psychosocial stress and the insulin resistance syndrome
Räikkönen, K., Keltikangas‐Järvinen, L., Adlercreutz, H., & Hautanen, A. (1996) · Metabolism · doi:10.1016/s0026-0495(96)90184-5 · Cited by 178
Nielsen, N. R., Kristensen, T. S., Schnohr, P., & Gronbaek, M. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwn157 · Cited by 176
Öhlin, B. (2004) · European Heart Journal · doi:10.1016/j.ehj.2004.03.003 · Cited by 143
The influence of psychosocial factors on survival after myocardial infarction
Jenkinson, C. M., Madeley, R. J., Mitchell, J. R. A., & Turner, I. D. (1993) · Public Health · doi:10.1016/s0033-3506(05)80122-2 · Cited by 84
Psychological distress, physical illness, and risk of coronary heart disease
Rasul, F., Stansfeld, S. A., Hart, C. L., & Smith, G. D. (2005) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2004.019786 · Cited by 73
A contemporary validation of the Reeder Stress Inventory
Metcalfe, C. D., Smith, G. D., Wadsworth, E. J. K., Sterne, J. A. C., Heslop, P., Macleod, J., & Smith, A. P. (2003) · British Journal of Health Psychology · doi:10.1348/135910703762879228 · Cited by 67
Perceived stress as a predictor of the self-reported new diagnosis of symptomatic CHD In older women
Strodl, E. S., Kenardy, J. A., & Aroney, C. N. (2003) · International Journal of Behavioral Medicine · doi:10.1207/s15327558ijbm1003_02 · Cited by 63
Lipid lowering for primary prevention
Yusuf, S., Lonn, E., & Bosch, J. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60357-3 · Cited by 52
Perceived Stress and Risk of Ischemic Heart Disease
Rod, N. H., Kristensen, T. S., Prescott, E., Strandberg‐Larsen, K., Schnohr, P., & Grønbæk, M. (2006) · Epidemiology · doi:10.1097/01.ede.0000220556.86419.76 · Cited by 49
Macleod, J., Smith, G. D., Heslop, P., Metcalfe, C. D., Carroll, D., & Hart, C. (2002) · Journal of Epidemiology & Community Health · doi:10.1136/jech.56.1.76 · Cited by 36
Flagged first, then by citations
Cited by
Sorted by citations
Havranek, E. P., Mujahid, M. S., Barr, D. A., Blair, I. V., Cohen, M. S., Cruz-Flores, S., Davey-Smith, G., Dennison-Himmelfarb, C. R., Lauer, M. S., Lockwood, D. W., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000228 · Cited by 1,472
Effects of stress on the development and progression of cardiovascular disease
Kivimäki, M., & Steptoe, A. (2018) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2017.189 · Cited by 1,197
State of the art review: depression, stress, anxiety, and cardiovascular disease
Cohen, B. E., Edmondson, D., & Kronish, I. M. (2015) · American Journal of Hypertension · doi:10.1093/ajh/hpv047 · Cited by 955
Self-citationLevine, G. N., Cohen, B. E., Commodore-Mensah, Y., Fleury, J., Huffman, J. C., Khalid, U., Labarthe, D. R., Lavretsky, H., Michos, E. D., Spatz, E. S., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000947 · Cited by 865
Heber, E., Ebert, D. D., Lehr, D., Cuijpers, P., Berking, M., Nobis, S., & Riper, H. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.5774 · Cited by 408
Metadata
- Authors
- Richardson, S., Shaffer, J. A., Falzon, L., Krupka, D., Davidson, K. W., & Edmondson, D.
- Affiliations
- Columbia University Irving Medical Center (US)
- Corresponding author
- Edmondson, Donald
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 110
- Issue
- 12
- Pages
- 1711-1716
- ISSN
- 0002-9149 (ISSN-L)
- PMC
- PMC3511594
- OpenAlex
- W2125315255
- Semantic Scholar
- 071040f82c0994a6069523d431dae51245242878
- Cited by
- 349
- References
- 28
- Citations by year
- 2026: 20 · 2025: 24 · 2024: 31 · 2023: 28 · 2022: 52 · 2021: 29 · 2020: 18 · 2019: 29 · 2018: 21 · 2017: 25 · 2016: 19 · 2015: 25 · 2014: 17 · 2013: 10
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institutes of Health (UL1RR024156)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- perceived stress, coronary artery disease, incident coronary heart disease, psychological stress, cardiovascular risk, self-reported stress, relative risk
- MeSH terms
- Coronary Disease, Humans, Perception, Risk Factors, Stress, Psychological
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
