Association of perceived stress with health status outcomes in patients with peripheral artery disease
Date
2021
Authors
Malik, A.O.
Poghni Peri-Okonny,
Gosch, K.
Thomas, M.B.
Mena-Hurtado, C.
Hiatt, W.
Aronow, H.D.
Jones, P.G.
Provance, J.
Labrosciano, C.
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Journal article
Citation
Journal of Psychosomatic Research, 2021; 140:110313-1-110313-7
Statement of Responsibility
Ali O. Malik, Poghni Peri-Okonny, Kensey Gosch, Merrill B. Thomas, Carlos Mena-Hurtado, William Hiatt, Herbert D. Aronow, Phillip G. Jones, Jeremy Provance, Clementine Labrosciano, Qurat-ul-ain Jelani, John A. Spertus, Kim G. Smolderen
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Abstract
Objective: To assess association of chronic self-perceived stress with health status outcomes of patients with peripheral artery disease. Methods: The PORTRAIT study is a prospective registry that enrolled 1275 patients with symptoms of peripheral artery disease across 16-sites in US, Netherlands, and Australia from June 2011 to December 2015. Demographics, comorbidities and diagnostic information was abstracted from chart review. Self-perceived stress was assessed using the 4-item perceived stress scale at baseline, 3- and 6-month follow-up. Scores range from 0 to 16 with higher scores indicating greater stress. Sum scores were calculated at each time point and averaged to quantify average exposure to stress from enrollment through 6 months. Disease-specific health status were assessed at baseline and 12-months using the peripheral artery disease questionnaire summary score. Results: The mean age of the analytical cohort (n = 1060) was 67.7 ± 9.3 years, 37.1% were females, and 82.3% were white. Comorbidities were highly prevalent with 80.9% having hypertension, 32.6% having diabetes, and 36.4% being smokers. In models adjusted for demographics, comorbidities, disease severity and socioeconomic status, having a higher average stress score was associated with poorer recovery (from baseline) in peripheral artery disease questionnaire summary score at 12-months (— 1.4 points per +1-point increase in averaged 4-point perceived stress score, 95% CI -2.1, — 0.6 p < 0.001). Conclusion: In patients with peripheral artery disease, experiencing higher chronic stress throughout the 6- months following their diagnosis, was independently associated with poorer recovery in 12-month diseasespecific health status outcomes. (ClinicalTrial.gov identifier: NCT01419080).
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