Work pressure, tension at home, financial difficulties … the list of causes of stress grows longer every day. There have been several studies in the past showing that stress can have negative effects on health (cardiovascular diseases, diabetes, high blood pressure and more). The Inserm researchers at unit 1018, “The Epidemiology and Public Health Research Centre”, working in collaboration with researchers from England and Finland have demonstrated that it is essential to be vigilant about this and to take it very seriously when people say that they are stressed, particularly if they believe that stress is affecting their health. According to the study performed by these researchers, with 7268 participants, such people have twice as much risk of a heart attack, compared with others.

These results have been published in European Heart Journal.

Today, stress is recognized as one of the main health problems. When people face a situation that is considered stressful, they may experience several physical, emotional and behavioural symptoms (anxiety, difficulty in concentrating, skin problems, migraines, etc.). Previous studies, particularly the recent studies performed within the Whitehall II cohort^[1], composed of several thousand British civil servants, have already shown that the physiological changes associated with stress can have an adverse effect on health.

Herman Nabi, Inserm researcher at Unit 1018 “The Epidemiology and Public Health Research Centre”, and his team went further and studied people who declared themselves to be stressed, in order to look more closely at whether there was a link between their feeling and the occurrence of coronary disease some years later.

Using a questionnaire prepared for the Whitehall II cohort, the participants were invited to answer the following question: “to what extent do you consider the stress or pressure that you have experienced in your life has an effect on your health”, the participants had the following answers to choose from: “not at all”, “a little”, “moderately”, “a lot” or “extremely”.

The participants were also asked about their stress level, as well as about other factors that might affect their health, such as smoking, alcohol consumption, diet and levels of physical activity. Arterial pressure, diabetes, body mass index and socio-demographic data such as marital status, age, sex, ethnicity and socio-economic status were also taken into account.

According to the results, the participants who reported, at the start of the study, that their health was “a lot” or “extremely” affected by stress had more than twice the risk (2.12 times higher) of having or dying from a heart attack, compared with those who had not indicated any effect of stress on their health.

From a clinical point of view, these results suggest that the patient’s perception of the impact of stress on their health may be highly accurate, to the extent that it can predict a health event as serious and common as coronary disease.

In addition, this study also shows that this link is not affected by differences between individuals related to biological, behavioural or psychological factors. However, capacities for dealing with stress do differ massively between individuals depending on the resources available to them, such as support from close friends and family.

According to Hermann Nabi, “the main message is that complaints from patients concerning the effect of stress on their health should not be ignored in a clinical environment, because they may indicate an increased risk of developing and dying of coronary disease. Future studies of stress should include perceptions of patients concerning the effect of stress on their health”.

In the future, as Hermann Nabi emphasizes, “tests will be needed to determine whether the risk of disease can be reduced by increasing the clinical attention given to patients who complain of stress having an effect on their health”.

^[1] Created in 1985, the Whitehall II cohort, consisting of British civil servants, is making a major contribution to research in social epidemiology and is considered internationally to be one of the main sources of scientific knowledge concerning social determinant factors for health.

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