Chronic stress and endothelial dysfunction: The multi-ethnic study of atherosclerosis (MESA)

Kiarri N. Kershaw*, Abbi D. Lane-Cordova, Mercedes R. Carnethon, Hilary A. Tindle, Kiang Liu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


BACKGROUND Endothelial dysfunction may represent an important link between chronic stress and cardiovascular disease (CVD) risk. However, few studies have examined the impact of chronic stress on endothelial dysfunction. The purpose of this study was to examine whether chronic stress was associated with flow-mediated dilation (FMD) and 2 biomarkers of endothelial dysfunction (intercellular adhesion molecule-1 (ICAM-1) and E-selectin) in a multiethnic sample of adults (ages 45-84 years). METHODS Data come from the baseline examination of Multi-Ethnic Study of Atherosclerosis participants. Chronic stress was assessed based on selfreport of the presence and severity of ongoing problems in 5 domains. FMD was obtained using high-resolution ultrasound; biomarkers were assayed in different subsets of participants. RESULTS Higher chronic stress was associated with lower absolute FMD (mm FMD) in models adjusted for demographic and socioeconomic characteristics (0.169 mm in high-stress participants vs. 0.178 and 0.179 mm in medium and low-stress participants; P for trend = 0.04). This association remained unchanged with further adjustment for behavioral and biological CVD risk factors. Higher stress was related to higher ICAM-1 in models adjusted for sociodemographic characteristics and biological risk factors (P for trend = 0.005), but this association attenuated with adjustment for cigarette smoking (P for trend = 0.07). Chronic stress was not associated with E-selectin. CONCLUSIONS Our findings suggest chronic stress is related to endothelial dysfunction, possibly in part through other stress-associated CVD risk factors such as cigarette smoking.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalAmerican Journal of Hypertension
Issue number1
StatePublished - Jan 2017


  • Blood pressure
  • Chronic stress
  • E-selectin
  • Endothelial dysfunction
  • Flow-mediated dilation
  • Hypertension
  • ICAM-1

ASJC Scopus subject areas

  • Internal Medicine


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