Stress linked to behaviors that increase heart disease, stroke risk in African-Americans

Daily stressors are associated with poor health behaviors that put African-American adults at greater risk of heart disease and stroke, a new study finds.

The results suggest that primary care doctors, cardiologists and other healthcare providers should ask their patients about stress to help them identify ways to manage and improve health outcomes, said Dr. LaPrincess C. Brewer, lead author of the Mayo Clinic-led study.

“The simple act of recognition of stress in our patients speaks volumes to them,” said Brewer, a cardiologist at the Mayo Clinic in Rochester, Minnesota. “[Talking about stress] also fosters a more genuine patient-physician relationship.”

In the study, published in the Journal of the American Heart Association, Brewer and her colleagues analyzed stress-related information along with behavioral and clinical data from 4,383 participants in the Jackson Heart Study, a Mississippi-based long-term study of cardiovascular disease in African-American adults.

The researchers used the American Heart Association’s Life Simple 7 measures to categorize each participant’s cardiovascular health as poor, intermediate or ideal. The measures include smoking, diet, physical activity, body mass index, blood pressure, cholesterol and blood sugar level.

Participants also completed surveys about their exposure to chronic stress, minor stressors and major life events, such as the death of a family member. The study found that African-American adults with higher stress levels were more likely to have overall poor cardiovascular health.

Longtime health disparities researcher Michelle Cardel said the study’s findings add to existing research on the health of African-Americans that shows stress is linked to quality of health.

The registered dietitian was the lead author of a study published in February that looked at the link between stress and metabolic syndrome, a cardiovascular disease risk measure that assesses blood pressure, obesity and cholesterol. The findings from that study, which also analyzed participant data from the Jackson Heart Study, showed that higher stress levels were linked to poor measures of metabolic syndrome.

African-Americans are much more likely than their white peers to die from heart disease or stroke, according to data from the Centers for Disease Control and Prevention. The data also show that risk factors for cardiovascular disease, including high blood pressure, diabetes and obesity, are more common among African-American adults than white adults.

The findings from the new study point to the need for culturally appropriate stress management strategies that could help African-American women and men improve their health and live longer, said Cardel, who was not involved in the new research. Those initiatives could encourage adults to exercise and to turn to friends and family to help them cope with stress, she said.

“But I think we need to be doing so much more than that,” said Cardel, an assistant professor of health outcomes and policy at the University of Florida. “We have to have public health interventions that are targeting [the many factors] that are contributing to … stress and discrimination in that vulnerable community.”

Brewer said addressing the relationship between stress and cardiovascular health that her study identified is more than doctors can do alone. She encourages state and federal legislators and public health officials to step up to the plate to help people improve their mental and physical health.

“It takes an entire community to recognize [stress] as a problem — and to be part of the solution,” said Brewer.

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