Skip to main content

Advertisement

Log in

The association between chronic stress type and C-reactive protein in the multi-ethnic study of atherosclerosis: does gender make a difference?

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

The objective of this study is to examine how chronic stress in major life domains [relationship, work, sympathetic-caregiving, financial] relates to CVD risk, operationalized using the inflammatory marker C-Reactive Protein (CRP), and whether gender differences exist. Participants were 6,583 individuals aged 45–84 years, recruited as part of the Multi-Ethnic Study of Atherosclerosis. Demographic and behavioral factors, health history, and chronic stress were self-reported. CRP was obtained through venous blood draw. In aggregate, gender by chronic stress interaction effects accounted for a significant, albeit small, amount of variance in CRP (P < .01). The sympathetic-caregiving stress by gender interaction was significant (P < .01); the work stress by gender effect approached significance (P = .05). Women with sympathetic-caregiving stress had higher CRP than those without, whereas no difference in CRP by stress group was observed for men. Findings underscore the importance of considering gender as an effect modifier in analyses of stress—CVD risk relationships.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CVD :

Cardiovascular disease

CRP :

C-reactive protein

References

  • Aiello, A. E., Diez-Roux, A., Noone, A. M., Ranjit, N., Cushman, M., & Tsai, M. Y. (2009). Socioeconomic and psychosocial gradients in cardiovascular pathogen burden and immune response: The multi-ethnic study of atherosclerosis. Brain, Behavior, and Immunity, 23, 663–671.

    Article  PubMed  CAS  Google Scholar 

  • Almeida, D. M. (2005). Resilience and vulnerability to daily stressors assessed via diary methods. Current Directions in Psychological Science, 14, 64–68. doi:10.1111/j.0963-7214.2005.00336.x.

    Article  Google Scholar 

  • Atienza, A. A., Henderson, P. C., Wilcox, S., & King, A. C. (2001). Gender differences in cardiovascular response to dementia caregiving. Gerontologist, 41, 490–498.

    Article  PubMed  CAS  Google Scholar 

  • Barker, D. B. (2007). Antecedents of stressful experiences: Depressive symptoms, self-esteem, gender, and coping. International Journal of Stress Management, 14, 333–349. doi:10.1037/1072-5245.14.4.333.

    Article  Google Scholar 

  • Barnett, R. C., Steptoe, A., & Gareis, K. C. (2005). Marital-role quality and stress-related psychobiological indicators. Annals of Behavioral Medicine, 30, 36–43.

    Article  PubMed  Google Scholar 

  • Benzaquen, L. R., Yu, H., & Rifai, N. (2002). High sensitivity C-reactive protein: An emerging role in cardiovascular risk assessment. Critical Reviews in Clinical Laboratory Sciences, 39, 459–497.

    Article  PubMed  CAS  Google Scholar 

  • Bierhaus, A., Humpert, P. M., & Nawroth, P. P. (2006). Linking stress to inflammation. Anesthesiology Clinics, 24, 325–340.

    Article  PubMed  CAS  Google Scholar 

  • Bilbo, S. D., Yirmiya, R., Amat, J., Paul, E. D., Watkins, L. R., & Maier, S. F. (2008). Bacterial infection early in life protects against stressor-induced depressive-like symptoms in adult rats. Psychoneuroendocrinology, 33, 261–269.

    Article  PubMed  Google Scholar 

  • Bild, D. E., Bluemke, D. A., Burke, G. L., Detrano, R., Diez Roux, A. V., & Folsom, A. R. (2002). Multi-ethnic study of atherosclerosis: Objectives and design. American Journal of Epidemiology, 156, 871–881.

    Article  PubMed  Google Scholar 

  • Black, P. H., & Garbutt, L. D. (2002). Stress, inflammation and cardiovascular disease. Journal of Psychosomatic Research, 52, 1–23.

    Article  PubMed  Google Scholar 

  • Bromberger, J. T., & Matthews, K. A. (1996). A longitudinal study of the effects of pessimism, trait anxiety, and life stress on depressive symptoms in middle-aged women. Psychology and Aging, 11, 207–213.

    Article  PubMed  CAS  Google Scholar 

  • Casas, J. P., Shah, T., Hingorani, A. D., Danesh, J., & Pepys, M. B. (2008). C-reactive protein and coronary heart disease: A critical review. Journal of Internal Medicine, 264, 295–314.

    Article  PubMed  CAS  Google Scholar 

  • Choi, J., & Chen, C. C. (2006). Gender differences in perceived work demands, family demands, and life stress among married Chinese employees. Management and Organization Review, 2, 209–229. doi:10.1111/j.1740-8784.2006.00041.x.

    Article  Google Scholar 

  • Clays, E., De Bacquer, D., Delanghe, J., Kittel, F., Van Renterghem, L., & De Backer, G. (2005). Associations between dimensions of job stress and biomarkers of inflammation and infection. Journal of Occupational and Environmental Medicine, 47, 878–883.

    Article  PubMed  Google Scholar 

  • Coussons-Read, M. E., Okun, M. L., & Nettles, C. D. (2007). Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy. Brain, Behavior, and Immunity, 21, 343–350.

    Article  PubMed  CAS  Google Scholar 

  • Danesh, J., Collins, R., Appleby, P., & Peto, R. (1998). Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: Meta-analyses of prospective studies. JAMA, 279, 1477–1482.

    Article  PubMed  CAS  Google Scholar 

  • Danesh, J., & Pepys, M. B. (2009). C-reactive protein and coronary disease: Is there a causal link? Circulation, 120, 2036–2039.

    Article  PubMed  Google Scholar 

  • Danesh, J., Whincup, P., Walker, M., Lennon, L., Thomson, A., & Appleby, P. (2000). Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ, 321, 199–204. (Clinical Research Ed.).

    Article  PubMed  CAS  Google Scholar 

  • Dantzer, R. (2009). Cytokine, sickness behavior, and depression. Immunology And Allergy Clinics Of North America, 29, 247–264.

    Article  PubMed  Google Scholar 

  • Davis, M. C., Burleson, M. H., & Kruszewski, D. M. (2011). Gender: Its relationship to stressor exposure, cognitive appraisal/coping processes, stress responses, and health outcomes. In R. J. Contrada & A. Baum (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 247–261). New York, NY: Springer Publishing Co.

    Google Scholar 

  • Davis, M. C., Matthews, K. A., & Twamley, E. W. (1999). Is life more difficult on Mars or Venus? A meta-analytic review of sex differences in major and minor life events. Annals of Behavioral Medicine, 21, 83–97. doi:10.1007/bf02895038.

    Article  PubMed  CAS  Google Scholar 

  • Davis, M. C., Zautra, A. J., Younger, J., Motivala, S. J., Attrep, J., & Irwin, M. R. (2008). Chronic stress and regulation of cellular markers of inflammation in rheumatoid arthritis: Implications for fatigue. Brain, Behavior, and Immunity, 22, 24–32.

    Article  PubMed  CAS  Google Scholar 

  • de Smet, P., Sans, S., Dramaix, M., Boulenguez, C., de Backer, G., & Ferrario, M. (2005). Gender and regional differences in perceived job stress across Europe. European Journal of Public Health, 15, 536–545.

    Article  PubMed  Google Scholar 

  • Dempster, A. P., Laird, N. M., & Rubin, D. B. (1977). Maximum likelihood from incomplete data via em algorithm. Journal of the Royal Statistical Society Series B-Methodological, 39, 1–38.

    Google Scholar 

  • Dohrenwend, B. P. (2006). Inventorying stressful life events as risk factors for psychopathology: Toward resolution of the problem of intracategory variability. Psychological Bulletin, 132, 477–495.

    Article  PubMed  Google Scholar 

  • Fortmann, S. P., Ford, E., Criqui, M. H., Folsom, A. R., Harris, T. B., & Hong, Y. (2004). CDC/AHA workshop on markers of inflammation and cardiovascular disease: Application to clinical and public health practice: Report from the population science discussion group. Circulation, 110, e554–e559.

    Article  PubMed  Google Scholar 

  • Fuligni, A. J., Telzer, E. H., Bower, J., Cole, S. W., Kiang, L., & Irwin, M. R. (2009). A preliminary study of daily interpersonal stress and C-reactive protein levels among adolescents from Latin American and European backgrounds. Psychosomatic Medicine, 71, 329–333.

    Article  PubMed  Google Scholar 

  • Graham, J. E., Glaser, R., Loving, T. J., Malarkey, W. B., Stowell, J. R., & Kiecolt-Glaser, J. K. (2009). Cognitive word use during marital conflict and increases in proinflammatory cytokines. Health Psychology, 28, 621–630.

    Article  PubMed  Google Scholar 

  • Gyllensten, K., & Palmer, S. (2005). The role of gender in workplace stress: A critical literature review. Health Education Journal, 64, 271–288.

    Article  Google Scholar 

  • Hallman, T., Burell, G., Setterlind, S., Oden, A., & Lisspers, J. (2001). Psychosocial risk factors for coronary heart disease, their importance compared with other risk factors and gender differences in sensitivity. Journal Cardiovascular Risk, 8, 39–49.

    Article  CAS  Google Scholar 

  • Hamer, M., Gibson, E. L., Vuononvirta, R., Williams, E., & Steptoe, A. (2006a). Inflammatory and hemostatic responses to repeated mental stress: Individual stability and habituation over time. Brain, Behavior, and Immunity, 20, 456–459.

    Article  PubMed  Google Scholar 

  • Hamer, M., Molloy, G. J., & Stamatakis, E. (2008). Psychological distress as a risk factor for cardiovascular events: Pathophysiological and behavioral mechanisms. Journal of the American College of Cardiology, 52, 2156–2162.

    Article  PubMed  Google Scholar 

  • Hamer, M., Williams, E., Vuonovirta, R., Giacobazzi, P., Gibson, E. L., & Steptoe, A. (2006b). The effects of effort-reward imbalance on inflammatory and cardiovascular responses to mental stress. Psychosomatic Medicine, 68, 408–413.

    Article  PubMed  Google Scholar 

  • Hansel, A., Hong, S., Camara, R. J. A., & von Kanel, R. (2010). Inflammation as a psychophysiological biomarker in chronic psychosocial stress. Neuroscience and Biobehavioral Reviews, 35, 115–121.

    Article  PubMed  Google Scholar 

  • Hapuarachchi, J. R., Chalmers, A. H., Winefield, A. H., & Blake-Mortimer, J. S. (2003). Changes in clinically relevant metabolites with psychological stress parameters. Behavioral Medicine, 29, 52–59.

    Article  PubMed  Google Scholar 

  • Haverkate, F., Thompson, S. G., Pyke, S. D., Gallimore, J. R., & Pepys, M. B. (1997). Production of C-reactive protein and risk of coronary events in stable and unstable angina. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. Lancet, 349, 462–466.

    Article  PubMed  CAS  Google Scholar 

  • Helgeson, V. S. (1994). Relation of agency and communion to well-being: Evidence and potential explanations. Psychological Bulletin, 116, 412–428.

    Article  Google Scholar 

  • Innes, K. E., Vincent, H. K., & Taylor, A. G. (2007). Chronic stress and insulin resistance-related indices of cardiovascular disease risk, part I: Neurophysiological responses and pathological sequelae. Alternative Therapies In Health And Medicine, 13(4), 46–52.

    PubMed  Google Scholar 

  • Jialal, I., Devaraj, S., & Venugopal, S. K. (2004). C-reactive protein: Risk marker or mediator in atherothrombosis? Hypertension, 44, 6–11.

    Article  PubMed  CAS  Google Scholar 

  • Jick, T. D., & Mitz, L. F. (1985). Sex differences in work stress. Academy of Management Review, 10, 408–420.

    Google Scholar 

  • Katrinchak, C., & Fritz, K. (2007). Clinical implications of C-reactive protein as a predictor of vascular risk. Journal Of The American Academy Of Nurse Practitioners, 19, 335–340.

    Article  PubMed  Google Scholar 

  • Kiecolt-Glaser, J. K., Loving, T. J., Stowell, J. R., Malarkey, W. B., Lemeshow, S., & Dickinson, S. L. (2005). Hostile marital interactions, proinflammatory cytokine production, and wound healing. Archives of General Psychiatry, 62, 1377–1384.

    Article  PubMed  Google Scholar 

  • Kiecolt-Glaser, J. K., & Newton, T. L. (2001). Marriage and health: His and hers. Psychological Bulletin, 127, 472–503.

    Article  PubMed  CAS  Google Scholar 

  • Kiecolt-Glaser, J. K., Preacher, K. J., MacCallum, R. C., Atkinson, C., Malarkey, W. B., & Glaser, R. (2003). Chronic stress and age-related increases in the proinflammatory cytokine IL-6. Proceedings of the National Academy of Sciences of the United States of America, 100, 9090–9095.

    Article  PubMed  CAS  Google Scholar 

  • Kopp, M. S., & Rethelyi, J. (2004). Where psychology meets physiology: Chronic stress and premature mortality—The Central-Eastern European health paradox. Brain Research Bulletin, 62, 351–367.

    Article  PubMed  Google Scholar 

  • LaMonte, M. J., Durstine, J. L., Addy, C. L., Irwin, M. L., & Ainsworth, B. E. (2001). Physical activity, physical fitness, and Framingham 10-year risk score: The cross-cultural activity participation study. Journal of Cardiopulmonary Rehabilitation, 21, 63–70.

    Article  PubMed  CAS  Google Scholar 

  • Lash, S. J., Eisler, R. M., & Southard, D. R. (1995). Sex differences in cardiovascular reactivity as a function of the appraised gender relevance of the stressor. Behavioral Medicine, 21, 86–94.

    Article  PubMed  CAS  Google Scholar 

  • Li, J., Yang, W., & Cho, S. I. (2006). Gender differences in job strain, effort-reward imbalance, and health functioning among Chinese physicians. Social Science and Medicine, 62, 1066–1077.

    Article  PubMed  Google Scholar 

  • Lind, L. (2003). Circulating markers of inflammation and atherosclerosis. Atherosclerosis, 169, 203–214.

    Article  PubMed  CAS  Google Scholar 

  • Lindfors, P. M., Meretoja, O. A., Toyry, R. P., Luukkonen, R. A., Elovainio, M. J., & Leino, T. J. (2007). Job satisfaction, work ability and life satisfaction among Finnish anaesthesiologists. Acta Anaesthesiologica Scandinavica, 51, 815–822.

    Article  PubMed  CAS  Google Scholar 

  • Liu, R. T., & Alloy, L. B. (2010). Stress generation in depression: A systematic review of the empirical literature and recommendations for future study. Clinical Psychology Review, 30, 582–593.

    Article  PubMed  Google Scholar 

  • Liu, C., Spector, P. E., & Shi, L. (2008). Use of both qualitative and quantitative approaches to study job stress in different gender and occupational groups. Journal of Occupational Health Psychology, 13, 357–370.

    Article  PubMed  Google Scholar 

  • Loosemore, M., & Waters, T. (2004). Gender differences in occupational stress among professionals in the construction industry. Journal of Management in Engineering, 20, 126–132. doi:10.1061/(asce)0742-597x(2004)20:3(126).

    Article  Google Scholar 

  • Marin, T. J., Martin, T. M., Blackwell, E., Stetler, C., & Miller, G. E. (2007). Differentiating the impact of episodic and chronic stressors on hypothalamic-pituitary-adrenocortical axis regulation in young women. Health Psychology, 26, 447–455.

    Article  PubMed  Google Scholar 

  • Matthews, K. A., Davis, M. C., Stoney, C. M., Owens, J. F., & Caggiula, A. R. (1991). Does the gender relevance of the stressor influence sex differences in psychophysiological responses? Health Psychology, 10, 112–120.

    Article  PubMed  CAS  Google Scholar 

  • McDade, T. W., Hawkley, L. C., & Cacioppo, J. T. (2006). Psychosocial and behavioral predictors of inflammation in middle-aged and older adults: The Chicago health, aging, and social relations study. Psychosomatic Medicine, 68, 376–381.

    Article  PubMed  Google Scholar 

  • McDonough, P., & Walters, V. (2001). Gender and health: Reassessing patterns and explanations. Social Science and Medicine, 52, 547–559.

    Article  PubMed  CAS  Google Scholar 

  • McIntyre, K. P., Korn, J. H., & Matsuo, H. (2008). Sweating the small stuff: How different types of hassles result in the experience of stress. Stress and Health: Journal of the International Society for the Investigation of Stress, 24, 383–392. doi:10.1002/smi.1190.

    Article  Google Scholar 

  • Miller, G. E., Chen, E., Sze, J., Marin, T., Arevalo, J. M. G., & Doll, R. (2008). A functional genomic fingerprint of chronic stress in humans: Blunted glucocorticoid and increased NF-kappaB signaling. Biological Psychiatry, 64, 266–272.

    Article  PubMed  CAS  Google Scholar 

  • Miller, D. B., & O’Callaghan, J. P. (2002). Neuroendocrine aspects of the response to stress. Metabolism: Clinical And Experimental, 51, 5–10.

    CAS  Google Scholar 

  • Miller, G. E., Rohleder, N., Stetler, C., & Kirschbaum, C. (2005). Clinical depression and regulation of the inflammatory response during acute stress. Psychosomatic Medicine, 67, 679–687.

    Article  PubMed  CAS  Google Scholar 

  • Mills, P. J., Ancoli-Israel, S., von K√§nel, R., Mausbach, B. T., Aschbacher, K., & Patterson, T. L. (2009). Effects of gender and dementia severity on Alzheimer’s disease caregivers’ sleep and biomarkers of coagulation and inflammation. Brain, Behavior, and Immunity, 23, 605–610.

    Article  PubMed  CAS  Google Scholar 

  • Mommersteeg, P. M. C., Vermetten, E., Kavelaars, A., Geuze, E., & Heijnen, C. J. (2008). Hostility is related to clusters of T-cell cytokines and chemokines in healthy men. Psychoneuroendocrinology, 33, 1041–1050.

    Article  PubMed  Google Scholar 

  • Nijm, J., Kristenson, M., Olsson, A. G., & Jonasson, L. (2007). Impaired cortisol response to acute stressors in patients with coronary disease. Implications for inflammatory activity. Journal of Internal Medicine, 262, 375–384.

    Article  PubMed  CAS  Google Scholar 

  • Nordestgaard, B. G., & Zacho, J. (2009). Lipids, atherosclerosis and CVD risk: is CRP an innocent bystander? Nutrition, Metabolism And Cardiovascular Diseases: NMCD, 19, 521–524.

    Article  CAS  Google Scholar 

  • O’Connor, D. B., Hendrickx, H., Dadd, T., Elliman, T. D., Willis, T. A., & Talbot, D. (2009). Cortisol awakening rise in middle-aged women in relation to psychological stress. Psychoneuroendocrinology, 34, 1486–1494. doi:10.1016/j.psyneuen.2009.05.002.

    Article  PubMed  Google Scholar 

  • Panagiotakos, D. B., Chrysohoou, C., Pitsavos, C., Antoniou, S., Vavouranakis, E., & Stravopodis, P. (2003). The association between occupational stress and the risk of developing acute coronary syndromes: The CARDIO2000 Study. Central European Journal of Public Health, 11, 25–30.

    PubMed  CAS  Google Scholar 

  • Pearson, T. A., Mensah, G. A., Alexander, R. W., Anderson, J. L., Cannon, R. O., I. I. I., & Criqui, M. (2003). Markers of inflammation and cardiovascular disease: Application to clinical and public health practice: A statement for healthcare professionals from the centers for disease control and prevention and the American heart association. Circulation, 107, 499–511.

    Article  PubMed  Google Scholar 

  • Pinquart, M., & Sorensen, S. (2006). Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. The Journals Of Gerontology. Series B, Psychological Sciences And Social Sciences, 61, P33–P45.

    Article  PubMed  Google Scholar 

  • Ramachandruni, S., Handberg, E., & Sheps, D. S. (2004). Acute and chronic psychological stress in coronary disease. Current Opinion in Cardiology, 19, 494–499.

    Article  PubMed  Google Scholar 

  • Ranjit, N., Diez-Roux, A. V., Shea, S., Cushman, M., Seeman, T., & Jackson, S. A. (2007). Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis. Archives of Internal Medicine, 167, 174–181.

    Article  PubMed  Google Scholar 

  • Rattazzi, M., Puato, M., Faggin, E., Bertipaglia, B., Zambon, A., & Pauletto, P. (2003). C-reactive protein and interleukin-6 in vascular disease: Culprits or passive bystanders? Journal of Hypertension, 21, 1787–1803.

    Article  PubMed  CAS  Google Scholar 

  • Ridker, P. M., Cushman, M., Stampfer, M. J., Tracy, R. P., & Hennekens, C. H. (1998). Plasma concentration of C-reactive protein and risk of developing peripheral vascular disease. Circulation, 97, 425–428.

    PubMed  CAS  Google Scholar 

  • Ridker, P. M., Hennekens, C. H., Buring, J. E., & Rifai, N. (2000). C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. The New England Journal of Medicine, 342, 836–843.

    Article  PubMed  CAS  Google Scholar 

  • Ross, R. (1999). Atherosclerosis—An inflammatory disease. The New England Journal of Medicine, 340(2), 115–126.

    Article  PubMed  CAS  Google Scholar 

  • Rozanski, A., & Kubzansky, L. D. (2005). Psychologic functioning and physical health: A paradigm of flexibility. Psychosomatic Medicine, 67, S47–S53.

    Article  PubMed  Google Scholar 

  • Shih, J. H., Eberhart, N. K., Hammen, C. L., & Brennan, P. A. (2006). Differential exposure and reactivity to interpersonal stress predict sex differences in adolescent depression. Journal of Clinical Child And Adolescent Psychology, 35, 103–115.

    Article  PubMed  Google Scholar 

  • Smith, T. W., Gallo, L. C., Goble, L., Ngu, L. Q., & Stark, K. A. (1998). Agency, communion, and cardiovascular reactivity during marital interaction. Health Psychology, 17, 537–545.

    Article  PubMed  CAS  Google Scholar 

  • Smith, T. W., Limon, J. P., Gallo, L. C., & Ngu, L. Q. (1996). Interpersonal control and cardiovascular reactivity: Goals, behavioral expression, and the moderating effects of sex. Journal of Personality and Social Psychology, 70, 1012–1024.

    Article  PubMed  CAS  Google Scholar 

  • Stafford, L. (2007). Interpersonal rejection sensitivity: Toward exploration of a construct. Issues in Mental Health Nursing, 28, 359–372.

    Article  PubMed  Google Scholar 

  • Steptoe, A., Hamer, M., & Chida, Y. (2007). The effects of acute psychological stress on circulating inflammatory factors in humans: A review and meta-analysis. Brain, Behavior, and Immunity, 21, 901–912.

    Article  PubMed  CAS  Google Scholar 

  • Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A., & Updegraff, J. A. (2000). Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Psychological Review, 107, 411–429.

    Article  PubMed  CAS  Google Scholar 

  • Toker, S., Shirom, A., Shapira, I., Berliner, S., & Melamed, S. (2005). The association between burnout, depression, anxiety, and inflammation biomarkers: C-reactive protein and fibrinogen in men and women. Journal of Occupational Health Psychology, 10, 344–362.

    Article  PubMed  Google Scholar 

  • Tracy, R. P., Lemaitre, R. N., Psaty, B. M., Ives, D. G., Evans, R. W., & Cushman, M. (1997). Relationship of C-reactive protein to risk of cardiovascular disease in the elderly. Results from the cardiovascular health study and the rural health promotion project. Arteriosclerosis, Thrombosis, and Vascular Biology, 17, 1121–1127.

    Article  PubMed  CAS  Google Scholar 

  • Troxel, W. M., Matthews, K. A., Bromberger, J. T., & Sutton-Tyrrell, K. (2003). Chronic stress burden, discrimination, and subclinical carotid artery disease in African American and Caucasian women. Health Psychology, 22, 300–309.

    Article  PubMed  Google Scholar 

  • von Kanel, R., Dimsdale, J. E., Mills, P. J., Ancoli-Israel, S., Patterson, T. L., & Mausbach, B. T. (2006). Effect of Alzheimer caregiving stress and age on frailty markers interleukin-6, C-reactive protein, and D-dimer. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 61, 963–969.

    Article  Google Scholar 

  • Young, E., & Korszun, A. (2010). Sex, trauma, stress hormones and depression. Molecular Psychiatry, 15, 23–28.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The Multi-Ethnic Study of Atherosclerosis (MESA) was supported by contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95166 from the National Heart, Lung, and Blood Institute. The authors thank the other investigators, staff, and participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. Smriti Shivpuri was supported by grant number T32HL079891-03 from the National Institutes of Health (during preparation of this manuscript). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Smriti Shivpuri.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shivpuri, S., Gallo, L.C., Crouse, J.R. et al. The association between chronic stress type and C-reactive protein in the multi-ethnic study of atherosclerosis: does gender make a difference?. J Behav Med 35, 74–85 (2012). https://doi.org/10.1007/s10865-011-9345-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-011-9345-5

Keywords

Navigation