Serious financial difficulties, psychological stress, and subclinical cardiovascular disease in Mexican women

Kaela Connors, Mario H. Flores-Torres, Adrian Cortés-Valencia, Tonatiuh Barrientos-Gutiérrez, Carlos Cantú-Brito, Beatriz Rodriguez, Martín Lajous, Unnur Valdimarsdóttir, Andrés Catzin-Kuhlmann*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To investigate the association between serious financial difficulties (SFD), stress, and cardiovascular health in women. Methods: We categorized 1759 employed and insured disease-free women from the Mexican Teachers’ Cohort according to their response to a question on SFD included in the Life Stressor Checklist-Revised administered in 2012 and 2016. We also measured perceived stress (n = 1598) and hair cortisol levels (n = 539) in study participants. Carotid intima-media thickness was measured, and carotid atherosclerosis determined in all participants. Results: Multivariable regression models indicated that women exposed to SFD had 1.6% (95% CI: 0.05, 3.2) higher mean intima-media thickness and 1.37 (95% CI: 1.02, 1.85) higher odds of carotid atherosclerosis relative to women without SFD. The magnitude of the observed associations was higher in women reporting longer duration of the event and higher emotional burden. Mediation analyses suggested a potential role of perceived stress and body mass index in these associations. Cortisol levels did not differ between groups. Conclusions: SFD was associated with subclinical cardiovascular disease among employed and insured women. Limiting stress and adiposity may be potential targets for interventions.

Original languageEnglish
Pages (from-to)38-43
Number of pages6
JournalAnnals of Epidemiology
Publication statusPublished - 1 Mar 2022

Bibliographical note

Funding Information:
This project was partly funded by an unrestricted investigator-initiated grant from AstraZeneca ( ISSNPCV0022 ) and by the National Council of Science and Technology's Funds for Health Research and Social Security ( CONACYT-SALUD 161,786 ) and Projects for Scientific Development to Deal with National Problems ( PDCPN2013–01–214,145 ).

Publisher Copyright:
© 2022 Elsevier Inc.

Other keywords

  • Financial stress
  • Psychological stress
  • Subclinical cardiovascular disease
  • Women
  • Cross-Sectional Studies
  • Carotid Intima-Media Thickness
  • Cardiovascular Diseases/epidemiology
  • Humans
  • Risk Factors
  • Hydrocortisone
  • Carotid Artery Diseases
  • Stress, Psychological/epidemiology
  • Female


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