Amir Vahedian-Azimi - Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Science, Tehran, Iran
Malihe Sadat Moayed - Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Science, Tehran, Iran

Introduction: During the last few decades, substantial research have been carried out identifying factors that contribute to the etiology and progression of Coronary Heart Disease (CHD). This systematic review and meta-analysis has been conducted to update and summarize the results of the published articles that examine the effect of perceived stress and its association with the incidence of CHD.Methods: In order to carry out this study, five electronic databases including PubMed, Scopus, Web of Science, Science Direct, and ProQuest were used to search for potentially relevant articles. Articles published from 1948 to November 2018 were investigated in this research. All cross- sectional, prospective observational cohort, and case – control studies were selected which had measured self-reported perceived stress and had assessed the incidence of CHD. From among all the potentially identified relevant articles, 10 articles met the criteria (n=165819). The incidence of CHD was defined as a new diagnosis of, Ischemic Heart Diseases (IHD) for, or Cardiovascular Disease (CVD) and mortality secondary to CHD.Results: Meta-analysis yielded a risk ratio of 1.382% [CI 95% (1.056-1.808), and P=0.019] for CHD, and an aggregate IHD risk of 1.206% [CI 95% (1.112-1.308), and P<0.0001]. Pooled estimate were 1.455% [CI 95% (1.088-1.944), and P<0.011] for mortality, which showed that perceived stress had a significant increasing effect on mortality.Conclusion: This systematic review and meta-analysis revealed that high levels of stress increases the risk of CHD, IHD and mortality. Lifestyle changes play an essential role in the clinical prevention of CVD.

Coronary heart disease, meta- analysis, Perceived stress, Stress