- Stress-related disorders show a “robust” and independent association with cardiovascular diseases (CVDs), especially with CVD onset before age 50 years.
Why this matters
- This study uses sibling comparisons.
- Editorial notes the potential for reverse causation, with existing CVD entailing proneness to stress disorders, but observes that findings with heart failure argue against reverse causation.
- HR for CVD in
- HR for ≥1 year: 1.28 (1.24-1.34).
- HRs for specific CVDs with stress-related disorder:
- Heart failure within first year of stress disorder diagnosis: 6.95 (1.88-25.68).
- Arrhythmia after 1 year: 1.12 (1.04-1.21).
- Arterial thromboembolism after 1 year: 2.02 (1.45-2.82).
- Strongest associations with early onset (
- Risk peaked just after stress disorder diagnosis.
- Population-based, sibling-controlled cohort study; 136,637 patients from Swedish registry, all diagnosed with stress-related conditions.
- Compared with 171,314 unaffected full siblings and 1,366,370 from the general population.
- Median follow-ups for patients, siblings, general population: 6.2, 6.9, and 6.5 years, respectively.
- Funding: Icelandic Research Fund; Karolinska Institute; others.
- Primary care information lacking.
- Siblings also could have experienced the stress but had undiagnosed stress disorders.