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TOPLINE:

Elevated perceived stress levels from adolescence to adulthood are associated with a higher risk for hypertension, obesity, and other cardiometabolic risk factors in young adults than lower perceived stress, new observational data show.

METHODOLOGY:

• This prospective study evaluated the association between perceived stress in childhood, adolescence, and adulthood and cardiometabolic risk in adulthood.
• The study included 276 participants (55.8% women) from the Southern California Children's Health Study (2003-2014) and a follow-up assessment (2018-2021).
• For participants in early childhood (mean age, 6.3 years), perceived stress was reported by their parents. Participants later self-reported stress during adolescence (mean age, 13.3 years) and young adulthood (mean age, 23.6 years).
• Based on their Perceived Stress Scale (PSS) score, participants were categorized into consistently high, decreasing, increasing, and consistently low stress patterns.
• Data for carotid artery intima-media thickness (CIMT), blood pressure (BP), obesity, percent body fat, android/gynoid (A/G) ratio, and glycated hemoglobin were used to calculate a cumulative cardiometabolic risk score.

TAKEAWAY:

• In adulthood, a higher PSS score was associated with increased CIMT (β, 0.01; P = .043), higher systolic BP (β, 1.27; P = .035) and diastolic BP (β, 0.94; P = .024), as well as an increased overall cardiometabolic risk (β, 0.12; P = .031).
• Individuals with consistently high vs low PSS score from adolescence to young adulthood had significantly higher cumulative cardiometabolic risk scores (β, 0.31; P = .036), A/G ratio (β, 0.07; P = .009), percent body fat (β, 2.59; P = .049), and greater odds of obesity (odds ratio [OR], 5.57; P = .006).
• The odds of obesity were significantly higher for individuals with decreasing PSS over time than among those with consistently low PSS (OR, 4.87; P = .019).

IN PRACTICE:

"Our findings suggest that perceived stress patterns over time have a far-reaching effect on various cardiometabolic measures including fat distribution, vascular health, and obesity. This could highlight the importance of stress management as early as in adolescence as a health protective behavior," said study author Fangqi Guo, PhD, postdoctoral research fellow at Keck School of Medicine, University of Southern California, Los Angeles, in a press release.

SOURCE:

This study, with first author Fangqi Guo, was published online on January 17, 2024, in Journal of the American Heart Association.

LIMITATIONS:

The findings may have limited generalizability as the study was conducted in a limited population of young adults primarily living in southern California. Stress in young childhood was perceived by parents, which may not represent the children's stress levels.

DISCLOSURES:

This study was funded by grants from the National Institute of Environmental Health Sciences, National Institutes of Health Environmental Influences on Child Health Outcomes consortium, National Institute of Environmental Health Sciences Southern California Environmental Sciences Center, and others. The authors declared no conflicts of interest.