Perceived Stress and Cause-specific Mortality among Men and Women: Results from a Prospective Cohort Study
Abstract
The authors assessed the effect of psychological stress on total and cause-specific mortality among men and women. In 1981-1983, the 12,128 Danish participants in the Copenhagen City Heart Study were asked two questions on stress intensity and frequency and were followed in a nationwide registry until 2004, with <0.1% loss to follow-up. Sex differences were found in the relations between stress and mortality (p = 0.02). After adjustments, men with high stress versus low stress had higher all-cause mortality (hazard ratio (HR) = 1.32, 95% confidence interval (CI): 1.15, 1.52). This finding was most pronounced for deaths due to respiratory diseases (high vs. low stress: HR = 1.79, 95% CI: 1.10, 2.91), external causes (HR = 3.07, 95% CI: 1.65, 5.71), and suicide (HR = 5.91, 95% CI: 2.47, 14.16). High stress was related to a 2.59 (95% CI: 1.20, 5.61) higher risk of ischemic heart disease mortality for younger, but not older, men. In general, the effects of stress were most pronounced among younger and healthier men. No associations were found between stress and mortality among women, except among younger women with high stress, who experienced lower cancer mortality (HR = 0.51, 95% CI: 0.28, 0.92). Future preventive strategies may be targeted toward stress as a risk factor for premature death among middle-aged, presumably healthy men.
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Cumulative exposure to daily stressors and exposure to traumatic stress can increase the risk of CVD.
“Studies have demonstrated that both cumulative exposure to daily stressors and exposure to traumatic stress can increase the risk of CVD. 15-17”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [17]
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- Authors
- Nielsen, N. R., Kristensen, T. S., Schnohr, P., & Gronbaek, M.
- Affiliations
- Danish National Institute of Public Health (DK)
- National Research Centre for the Working Environment (DK)
- Bispebjerg Hospital (DK)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-07-02
- Volume
- 168
- Issue
- 5
- Pages
- 481-491
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2102956699
- Cited by
- 176
- References
- 26
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 6 · 2023: 5 · 2022: 17 · 2021: 14 · 2020: 8 · 2019: 6 · 2018: 10 · 2017: 11 · 2016: 9 · 2015: 11 · 2014: 14 · 2013: 16 · 2012: 15
- FWCI
- 5.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Funders
- Hjerteforeningen
- Sundhed og Sygdom, Det Frie Forskningsråd
- Lundbeckfonden
- H. Lundbeck A/S
- Medical Research Council
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Health › Health disparities and outcomes
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- perceived stress, psychological stress, cause-specific mortality, all-cause mortality, sex differences, respiratory mortality, suicide, ischemic heart disease mortality, cancer mortality, premature mortality, middle-aged men, Copenhagen City Heart Study
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Death Certificates, Denmark, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neoplasms, Prospective Studies, Surveys and Questionnaires, Respiratory Tract Diseases, Risk Factors, Sampling Studies, Stress, Psychological, Cohort Studies, Multivariate Analysis, Proportional Hazards Models, Sex Distribution
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