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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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“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]
Citations
Cites
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
Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study
Schulz, R., & Beach, S. R. (1999) · JAMA · doi:10.1001/jama.282.23.2215 · Cited by 3,340
The concept of allostasis in biology and biomedicine
McEwen, B. S., & Wingfield, J. C. (2003) · Hormones and Behavior · doi:10.1016/s0018-506x(02)00024-7 · Cited by 3,302 · cited 1×
“The human body is in a state of dynamic equilibrium, also known as allostasis ( 23 ).”
BackgroundRosengren, A., Hawken, S., Ôunpuu, S., Sliwa, K., Zubaid, M., Almahmeed, W. A., Blackett, K. N., Sitthi-amorn, C., Sato, H., & Yusuf, S. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17019-0 · Cited by 2,414
Sex differences in HPA axis responses to stress: a review
Kudielka, B. M., & Kirschbaum, C. (2005) · Biological Psychology · doi:10.1016/j.biopsycho.2004.11.009 · Cited by 1,624
Stress, depression, the immune system, and cancer
Reiche, E. M. V., Nunes, S. O. V., & Morimoto, H. K. (2004) · The Lancet Oncology · doi:10.1016/s1470-2045(04)01597-9 · Cited by 1,364
Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees
Mika Kivimaki, B. (2002) · BMJ · doi:10.1136/bmj.325.7369.857 · Cited by 919
Sudden Cardiac Death Triggered by an Earthquake
Leor, J., Poole, W. K., & Kloner, R. A. (1996) · New England Journal of Medicine · doi:10.1056/nejm199602153340701 · Cited by 819
Mortality in parents after death of a child in Denmark: a nationwide follow-up study
Li, J., Precht, D. H., Mortensen, P. B., & Olsen, J. (2003) · The Lancet · doi:10.1016/s0140-6736(03)12387-2 · Cited by 553
Neuroendocrinology and pathophysiology of the stress system
STRATAKIS, C. A., & CHROUSOS, G. P. (1995) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1995.tb44666.x · Cited by 533
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Teychenne, M. J., Olstad, D. L., Turner, A. I., Costigan, S. A., & Ball, K. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15040586 · Cited by 12
Poirat, L., Gaye, B., Perier, M., Thomas, F., Guibout, C., Climie, R. E., Offredo, L., Tafflet, M., Lemogne, C., Pannier, B., et al. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.06.040 · Cited by 12
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Agbaria, Q., & Mokh, A. A. (2022) · Current Psychology · doi:10.1007/s12144-021-02669-5 · Cited by 14
JACC Study Group, Fujino, Y., Tanabe, N., Honjo, K., Suzuki, S., Shirai, K., Iso, H., & Tamakoshi, A. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-398 · Cited by 11
Leontopoulou, S. (2012) · Social indicators research series · doi:10.1007/978-94-007-4963-4_15 · Cited by 11
Alhurani, A. S., Dekker, R. L., Tovar, E. G., Bailey, A. L., Lennie, T. A., Randall, D. C., & Moser, D. K. (2014) · SAGE Open Medicine · doi:10.1177/2050312114552093 · Cited by 11
Childhood exposure to birth registration laws and old‐age mortality
Noghanibehambari, H., & Fletcher, J. M. (2022) · Health Economics · doi:10.1002/hec.4643 · Cited by 10
Roepke, S. K., & Dong, X. (2015) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13613 · Cited by 13
Klassisches oder digitales Stressmanagement im Setting Hochschule?
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Enjoying hobbies is related to desirable cardiovascular effects
Saihara, K., Hamasaki, S., Ishida, S., Kataoka, T., Yoshikawa, A., Orihara, K., Ogawa, M., Oketani, N., Fukudome, T., Atsuchi, N., et al. (2010) · Heart and Vessels · doi:10.1007/s00380-009-1173-y · Cited by 10
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Faro, A., & Pereira, M. E. (2013) · Psicologia Saúde & Doenças · doi:10.15309/13psd140107 · Cited by 10
MTHFR gene methylation is associated with perceived stress in healthy young adults
Jiménez, K. M., Pereira‐Morales, A. J., & Forero, D. A. (2018) · Psychiatric Genetics · doi:10.1097/ypg.0000000000000196 · Cited by 10
Gellisch, M., Schäfer, T., Yahya, I., Joswig, M., Cheng, X., Moroşan‐Puopolo, G., & Brand‐Saberi, B. (2023) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe13080109 · Cited by 10
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Corazon, S. S., Stigsdotter, U. K., Ekholm, O., Pedersen, P. V., Scopelliti, M., & Giuliani, M. V. (2010) · Journal of Applied Biobehavioral Research · doi:10.1111/j.1751-9861.2011.00059.x · Cited by 8
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Eze, U. I. H., Adeniji, B. A., & IHEANACHO, C. O. (2023) · African Health Sciences · doi:10.4314/ahs.v23i1.58 · Cited by 2
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Nielsen et al. Respond to "Stress and Mortality"
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Lee, Y., & Kim, Y. (2026) · Journal of Community Health Nursing · doi:10.1080/07370016.2026.2630818 · Cited by 1
Gautam, D. S. (2018) · Journal of Medical Science And clinical Research · doi:10.18535/jmscr/v6i5.61 · Cited by 1
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Filtness, T. W. (2013) · Brunel University Research Archive (BURA) (Brunel University London)
Alhurani, A. S. (2016) · UKnowledge (University of Kentucky) · doi:10.13023/etd.2016.191
Jean-Francois, P. (2013) · Minds at UW (University of Wisconsin)
Chevvuri, R., Naveen, N., Yunus, G., Tiwari, R. V., Sharma, H., & Verma, S. (2019) · Journal of Indian Association of Public Health Dentistry · doi:10.4103/jiaphd.jiaphd_132_18
Khan, M. S., Rahpoto, M. S., & Mangnejo, G. M. (2020) · Research Journal of Social Sciences & Economics Review (RJSSER) · doi:10.36902/rjsser-vol1-iss3-2020(232-238
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Zhang, W., Peng, S., Fu, J., Xu, K., Wang, H., Jin, Y., Yang, T., & Cottrell, R. R. (2021) · doi:10.2196/preprints.28186
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Metadata
- 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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