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Psychological distress and incident cardiovascular disease independent of life's essential 8: a prospective cohort study.

Nami Lee·Kyoung Hwa Ha·Hyun Young Lee·Sang Joon Son·Seung Jin Han
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Abstract

BACKGROUND: Although psychological stress has emerged as an important determinant of cardiovascular disease (CVD) risk, it remains excluded from the recently updated cardiovascular health (CVH) metrics, known as Life's Essential 8 (LE8). This study aimed to examine the association between psychological distress and the incidence of CVD, independent of Life's Essential 8 metrics, in a large Korean adult population. METHODS: This study included 6,410 participants from the Korean Genome and Epidemiology Study Ansan-Ansung cohort, who had no history of CVD and had complete baseline data on psychological distress and Life's Essential 8 cardiovascular health (LE8 CVH) metrics. Psychological distress was assessed using the Psychosocial Wellbeing Index Short Form (PWI-SF). CVD events were identified based on participants' self-reports of physician-diagnosed conditions: myocardial infarction, stroke, coronary artery disease, and congestive heart failure. Cox proportional hazards models were used to examine the association between PWI-SF scores and incident CVD, adjusting for age, sex, residential area, educational attainment, household income, and LE8 CVH metrics. RESULTS: During a median follow-up of 13.8 years, 500 new cases of CVD were identified. Higher PWI-SF scores were independently associated with an increased risk of CVD after adjusting for LE8 CVH metrics and other potential confounders (hazard ratio: 1.321; 95% confidence interval: 1.067-1.636; p = 0.011). CONCLUSION: These findings suggest that higher levels of psychological distress are independently associated with an increased risk of CVD, even after accounting for established LE8 CVH metrics. Incorporating psychological distress into future CVH assessments may enhance risk stratification and prevention strategies.

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HumansCardiovascular DiseasesFemaleProspective StudiesMaleIncidenceMiddle AgedRepublic of KoreaPsychological DistressStress, PsychologicalAdultRisk FactorsProportional Hazards ModelsAgedCardiovascular health metricscardiovascular diseasespsychological distressJournal ArticleResearch Support, Non-U.S. Gov't

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Nami Lee, Kyoung Hwa Ha, Hyun Young Lee, Sang Joon Son, Seung Jin Han. 2026-05-04. Psychological distress and incident cardiovascular disease independent of life's essential 8: a prospective cohort study.. https://doi.org/10.1080/07853890.2026.2665515

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Adult subjectAged subjectCardiovascular Diseases subjectFemale subjectHumans subjectIncidence subjectJournal Article subjectJournal Article; Research Support, Non-U.S. Gov't resourceMale subjectMiddle Aged subject

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