Coping Strategies Influence Cardiometabolic Risk Factors in Chronic Psychological Stress: A Post Hoc Analysis of A Randomized Pilot Study.

Deborah Armborst,Daniela Rösler,Christine Metzner,Norman Bitterlich,Roswitha Siener,Birgit Alteheld

doi:10.3390/nu14010077

Deborah Armborst, Daniela Rösler + Show 4 more

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https://doi.org/10.3390/nu14010077

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Abstract

Chronic psychological stress can result in physiological and mental health risks via the activation of the hypothalamic–pituitary–adrenal (HPA) axis, sympathoadrenal activity and emotion-focused coping strategies. The impact of different stress loads on cardiometabolic risk is poorly understood. This post hoc analysis of a randomized pilot study was conducted on 61 participants (18–65 years of age) with perceived chronic stress. The Perceived Stress Questionnaire (PSQ30), Psychological Neurological Questionnaire (PNF), anthropometric, clinical and blood parameters were assessed. Subjects were assigned to ‘high stress’ (HS; PSQ30 score: 0.573 ± 0.057) and ‘very high stress’ (VHS; PSQ30 score: 0.771 ± 0.069) groups based on the PSQ30. Morning salivary cortisol and CRP were elevated in both groups. Visceral adiposity, elevated blood pressure and metabolic syndrome were significantly more frequent in the HS group vs. the VHS group. The fatty liver index (FLI) was higher (p = 0.045), while the PNF score was lower (p < 0.001) in the HS group. The HS group was comprised of more smokers (p = 0.016). Energy intake and physical activity levels were similar in both groups. Thus, high chronic stress was related to visceral adiposity, FLI, elevated blood pressure and metabolic syndrome in the HS group, while very high chronic stress was associated with psychological–neurological symptoms and a lower cardiometabolic risk in the VHS group, probably due to different coping strategies.

Highlights

The present study shows that the stress load can be coped with in different ways and that the coping strategy is crucial for cardiometabolic risk
Further limitations are the lack of a control group, the wide age range of the participants (18 to 65 years of age) and the impossibility of an analysis of sex differences due to the small number of participants. These findings indicate that high perceived chronic stress is related to visceral obesity, elevated blood pressure, metabolic syndrome and high liver fat, with a high cardiometabolic risk due to stress-induced disturbances of the HPA axis and maladaptive coping strategies used
A very high perceived chronic stress load seemed to be rather associated with mental health risk than with cardiometabolic risk

Summary

Introduction

Chronic psychological stress is increasingly recognized as a significant contributor to mental and physiological disorders in modern societies [1,2,3]. The term ‘stress’ is used to describe physiological and behavioral responses to real or perceived intrinsic or extrinsic stimuli or ‘stressors’ threatening homeostasis [4,5]. The brain is the central organ of the perception and the response to stress. It operates as part of a complex and non-linear network via the sympathetic and parasympathetic systems, the hypothalamic–

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