High stress during adolescence tied to obesity, high blood pressure in adulthood

By American Heart Association News

Juan Algar/Moment via Getty Images
(Juan Algar/Moment via Getty Images)

Young adults who reported consistently high levels of stress beginning in adolescence were more likely to develop cardiometabolic risk factors, such as obesity and high blood pressure, than their peers who felt less stress as they grew up, new research suggests.

The study, published Wednesday in the Journal of the American Heart Association, points to the need for adopting stress management strategies early in life to lower future risk for health problems, including heart disease and Type 2 diabetes.

"Understanding the effects of perceived stress starting in childhood is important for preventing, lessening or managing higher cardiometabolic risk factors in young adults," study author Dr. Fangqi Guo said in a news release. Guo is a postdoctoral research fellow at the University of Southern California's Keck School of Medicine in Los Angeles.

The findings suggest that perceived stress patterns over time have a far-reaching effect on cardiometabolic measures such as fat distribution, vascular health and obesity, Guo said. "This could highlight the importance of stress management as early as in adolescence as a health protective behavior."

Cardiometabolic risk factors include obesity, Type 2 diabetes or prediabetes, high cholesterol and high blood pressure. They often occur together and are a significant cause of cardiovascular disease. Cardiometabolic diseases, including cardiovascular disease and Type 2 diabetes, were the leading chronic health conditions in 2020, accounting for nearly 25% of all deaths in the U.S., according to American Heart Association statistics.

A 2017 AHA report found childhood adversities can affect cardiometabolic health over a person's life. Perceived stress also has been shown in recent decades to contribute to cardiometabolic health issues.

In the new study, researchers analyzed data for 276 people enrolled in the Southern California Children's Health Study. Participants were enrolled by their parents from 2003 to 2014 at an average 6 years old when they took their first health assessment. They took follow-up assessments as adolescents and young adults, from 2018 to 2021. Participants were an average 13 years old during the adolescent assessment and 24 on average when evaluated as adults.

During each assessment, participants answered questions from a four-item Perceived Stress Scale, a widely used method that asks about feelings and thoughts during the past month. Parents reported perceived stress for the youngest participants. The participants were then classified into four groups based on their stress levels: consistently high, decreasing, increasing and consistently low.

To assess cardiometabolic health, researchers took a series of health measurements, including blood pressure and weight. They looked at neck artery thickness to see how well blood was flowing. They measured hemoglobin A1C levels, which show average blood glucose levels over several months, to determine diabetes status. They also measured percentage of body fat and whether participants had a lot of body fat around the abdomen, which is associated with a high risk for cardiovascular disease and Type 2 diabetes.

People who reported higher levels of stress from the teenage years through adulthood were more likely to have high blood pressure, higher total body fat and more fat around their bellies, worse vascular health and a higher risk for obesity than those who reported feeling less stressed.

"Although we assumed that perceived stress patterns should have some association with cardiometabolic measures, we did not expect such consistent patterns across various risk factors," Guo said.

He encouraged health care professionals to consider using the Perceived Stress Scale during clinic visits. "This way, those with higher stress levels can be identified and receive treatment earlier."


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