Association of psychosocial stressors with metabolic syndrome severity among African Americans in the Jackson Heart Study

Introduction: Using Jackson Heart Study (JHS) data, we assessed the association between perceived psychosocial stressors and metabolic syndrome (MetS) severity in African American adults. Methods: Participants included 3870 African American JHS participants aged 21-95 years (63.1% women; mean age 53.8 +/- 13.0). Psychosocial stressors assessed included: major life events (MLEs); global stress; and weekly stress inventory. Each stress measure was classified into tertiles (low, medium, and high). Associations of psychosocial stressors with a sex- and race/ethnic-specific MetS severity Z-score were examined after adjustment for demographics and MetS risk factors (i.e., nutrition, physical activity, smoking status, and alcohol consumption). Results: Independent of lifestyle factors, participants who reported high (versus low) perceived global stress and MLEs had significantly greater MetS severity (p = .0207 and p = .0105, respectively). Weekly stress was not associated with MetS severity. Compared to men, women reported significantly higher global stress and MLEs (p < 0.0001). A significant interaction between sex and MLEs (p = .0456) demonstrated men significantly increased their MetS severity at medium levels of stress, whereas women's MetS severity was significantly increased at high levels of MLEs. Conclusions: In the total sample, higher reported global stress and MLEs were associated with increased risk of MetS severity, while weekly stress was not. Men's and women's stress responses to MLEs were differentially associated with MetS severity, with male MetS severity increasing significantly at lower levels of MLEs relative to women's MetS severity. These data may have implications for targeting stress-related factors in interventions to improve cardiometabolic health in African American adults.