Mental Stress Underestimation and Ischemic Heart Disease: a Japan Collaborative Cohort Study
 Patraphol Panitvorapume, Iso Hiroyasu. Osaka, Japan


Abstract 
Background: Several studies have demonstrated that mental stress is associated with ischemic heart disease(IHD). However, association between mental stress underestimation(MSU) and IHD is unknown. Our aim was to implement a new method of calculating MSU and clarify the association. 
Method: We performed a retrospective cohort of the Japan Collaborative Cohort Study (JACC Study). Statistical calculations were conducted using Statistical Analysis Software. 110,972 subjects (46,465 men and 64,327 women), aged 40 to 79 years at baseline, were eligible for follow-up. Propensity scores of answering yes to the stress question were calculated from the logistic regression between stress question and other 7 mental questions. Subjects with propensity score less than 0.01 were considered to be underestimating mental stress.  Cox regression was performed after adjusting confounders.
Results: We found that mortality risk from IHD significantly increased in stress underestimating women(1.59, 95%CI 1.07 to 2.38). No statistically significant increase in mortality risk was found in men.
Limitations: There was no direct evidence that support the association between the 7 mental questions and MSU. However, a significantly larger proportion of subjects with propensity score less than 0.01 answered no to the stress question and thus justified the cut-off.
Conclusion: Mental stress underestimation may increase mortality from ischemic heart disease. 

Recent Publications 

1. Iso H, et al. (2002) Perceived Mental Stress and Mortality From  Cardiovascular Disease Among Japanese Men and Women. Circulation  106:1229-1236.
2. Izawa S, et al. (2016) Stress Underestimation and Mental Health Outcomes in Male Japanese Workers: a 1-Year Prospective Study. International Journal of Behavioral Medicine 23: 664.
3. White M, et al. (2008) An investigation of whether patients with post-traumatic stress disorder overestimate the probability and cost of future negative events. Journal of Anxiety Disorders 22:1244-1254.
4. Ravaja N, et al. (2000) Relationships between hostility and physiological coronary heart disease risk factors in young adults: the moderating influence of depressive tendencies. Psychological Medicine 30(2):381-393.
5.  Honig A, et al. (2000) Psychoimmunology as a common pathogenetic pathway in myocardial infarction, depression and cardiac death. Current Opinion in Psychiatry 13(6):661-664.

Biography
Patraphol Panitvorapume is a medical student of Osaka university and has his expertise in public health and epidemiology.
Email:
yuukikagaku@hotmail.com
Tel:
+86 8043742993