Nabi et al, Euro Heart Journal, Coronary Heart Disease Risk from Stress

Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study

European Heart Journal, Clinical Research

Hermann Nabi, Mika Kivimaki, G. David Batty, Martin J. Shipley, Annie Britton, Eric J. Brunner, Jussi Vahtera, Cedric Lemogne, Alexis Elbaz, Archana Singh-Manoux


Despite these potential limitations, the present findings represent an important contribution to research on stress. Relating individuals’ perceptions of adverse effects of stress on health with their future risk of CHD has far-reaching theoretical and clinical implications.

From a theoretical perspective, this implies that the perceived impact of stress on health is a valid concept and should be considered for inclusion in future studies on the association between stress and health. From a clinical perspective, these findings suggest that participant’s perception of the impact of stress on their health may indeed be accurate, with regard to it being associated with adverse health outcomes. Thus, complaints of adverse stress impact on health should not be ignored as they may indicate increased risk of developing CHD.

Assessing a subjective perception of adverse impact of stress on health might be considered as a part of managing patients with stress-related complaints in clinical settings. Given the robustness of the association between the perceived impact of stress on health and incident CHD after multivariate adjustment for a range of covariates, it is reasonable to assume that a simple question, such as the one used in the present study, could be used in general or specialized care settings.

Although, stress, anxiety, and worry are thought to have increased in recent years, we found that only participants (8%) who reported stress to have affected their health ‘a lot or extremely’ had an increased risk of CHD. In the future, randomized controlled trials are needed to determine whether disease risk can be reduced by increasing clinical attention to those who complain that stress greatly affects their health.

Download the research paper →