Link of stress to heart disease is artefactual

The link between psychological stress and heart disease may be an artefact. In an observational study of Scottish men (p 1247), Macleod and colleagues found more angina in men who had more perceived stress, but for ischaemia there was a weak trend in the opposite direction. A higher stress level was associated with a higher rate of admission for cardiovascular disease but with lower mortality. The authors say that stressed patients report more symptoms but these do not reflect physical disease. These findings cast doubt over the associations between psychosocial measures and disease outcomes reported in other studies.

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Relevant Article

Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men • Commentary: Psychosocial factors and healthstrengthening the evidence base

John Macleod, George Davey Smith, Pauline Heslop, Chris Metcalfe, Douglas Carroll, Carole Hart, and John Lynch
BMJ 2002 324: 1247. [Abstract] [Full Text] [PDF]