Association between Psychosocial Stress and Sub-Clinical Cardiovascular Disease among women living in Metro Atlanta Area: A cross-sectional study Restricted; Files Only
Kauser, Tanveer (Summer 2025)
Abstract
Background. Psychosocial stress (PS) is known to negatively affect cardiovascular health, with studies showing higher rates of cardiovascular disease (CVD) and worse outcomes in individuals experiencing depression, anxiety, post-traumatic stress disorder, and other PS conditions. Endothelial dysfunction is a precursor of CVD and precedes its onset by decades. The relationship between early vascular disease and PS in African American women, a population facing disproportionate levels of stress and cardiovascular risk, has not been studied in detail and was the focus of this study.
Objectives. We aimed to examine the relationship between psychosocial stress (PS) and sub-clinical cardiovascular disease among young-middle aged women residing in the Metro Atlanta.
Methods. In a retrospective cross-sectional study in a subset of 88 women, including 81 (92%) non-Hispanic African American, recruited in the Women’s Interagency HIV Study (WIHS) between 2019 to 2023, we analyzed results of the flow-mediated dilation (FMD). Regression was utilized to investigate the relationship between PSS-10 score and FMD after Linear adjustment for demographics and cardiovascular risk factors.
Results. Overall, 39 (44.3%) had moderate or high PSS scores, defined as a score above 14, with a median score of 13 (IQR: 8.0 - 19.25) and a median FMD of 4.21% (IQR: 2.32% - 5.86%). Those with moderate or high PSS scores were younger (51.9 vs 56.4 years), have a history of smoking (57.3% vs 29.6, P = 0.038), and were less likely to be diagnosed with HIV (44.2% vs 75.6%) than those with low PSS scores. Participants with moderate/high PSS score trended to have a lower FMD (4.94%-4.0%, p=0.06) compared to those in the low PSS group, a finding that was particularly evident in women living with HIV. However, this relationship was not significant after adjustment of demographic features and risk factors.
Conclusions. In African American women, there is a trend towards endothelial dysfunction with higher levels of PS, particularly in women with HIV.
Table of Contents
Table of Contents
1. Introduction
Background
Significance of Study
Problem Statement
Objectives and Hypothesis
2. Literature Review
Global burden of cardiovascular disease in women
Contributing factors to cardiovascular disease in women living in urban area
Cardiovascular risk profiles in women living with chronic conditions
Global burden of psychosocial stress in women
Contributing factors to combine psychosocial stress in women
Role of endothelial dysfunction in vascular health
Assessment of psychosocial stress
3. Methods
Study Design and Setting
Study size and Power of the study
Data Collection
Variables
Data Cleaning
Statistical Analysis
4. Results
5. Discussion
Findings
Strengths and Limitations
Recommendations for Future Conclusion
6. References
7. Appendix
A - Code Book
B – Perceived Stress Scale 10
C – Data Output
8. Figures
9. Tables
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File download under embargo until 20 August 2026 | 2025-07-29 00:34:35 -0400 | File download under embargo until 20 August 2026 |
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