Observational studyPsychoneuroendocrinology2026
Psychobiological reactivity to acute psychological stress as a predictor of cardiovascular disease and mortality: The Multi-Ethnic Study of Atherosclerosis.
Observational study in Psychoneuroendocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Stressful exposure from the 2004 Indian Ocean Tsunami drives long-term changes in thyroid hormone physiology.bioRxiv : the preprint server for biology · 2026Article
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Authors and funding
17 authors.
Funding
Abstract
backgroundDysregulated psychobiological reactivity to acute psychological stress is associated with subclinical cardiovascular disease (CVD) risk, but its association with clinical CVD and mortality remains unclear-especially when considering both exaggerated and blunted responses, non-cardiovascular biomarkers, and potential racial/ethnic differences. This study aimed to test (1) relationships between multi-system stress reactivity and CVD/mortality, and (2) effect modification by race/ethnicity.
methodsParticipants were CVD-free adults (N = 957, age=69 ± 9 years, 56 % female, 27 % non-Hispanic White, 32 % non-Hispanic Black, 41 % Hispanic) enrolled in the Multi-Ethnic Study of Atherosclerosis. The following responses to a standardized psychological stress protocol were recorded: blood pressure (BP), heart rate, heart rate variability (HRV), salivary alpha-amylase (sAA), and cortisol. Participants were followed for a median of 8 years. Covariate-adjusted Cox proportional hazard models investigated associations of stress reactivity (baseline-to-stress changes: low/blunted: ≤25th percentile; intermediate/moderate [reference]: 26-74th; high/exaggerated: ≥75th) with incident CVD (N = 111) and all-cause mortality (N = 114). Race/ethnicity was tested as an effect modifier.
resultsStress reactivity was not linked with CVD incidence. Blunted diastolic BP reactivity was associated with premature all-cause mortality (HR=1.92, 95 % CI: 1.03-3.56). Exaggerated (HR=0.58, 95 % CI: 0.35-0.98) and blunted (HR=0.52, 95 % CI: 0.30-0.89) sAA reactivity were associated with reduced mortality risk. Race/ethnicity was not an effect modifier (all p for interaction > 0.05).
conclusionsBlunted DBP reactivity may serve as an early marker of increased mortality risk; randomized trials should test whether interventions that normalize DBP reactivity improve long-term survival. Further research should explore why dysregulated sAA reactivity was associated with lower mortality risk.
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