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Associations between Chronic Stress, Resilience Resources, and Cardiovascular Health among Young Adults in Puerto Rico: the PR-OUTLOOK study

Health & MedicineMind & Behavior

Key takeaway

A study in Puerto Rico found that chronic stress and resilience resources may impact heart health in young adults, highlighting the importance of addressing mental and physical well-being as a public health priority.

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Quick Explainer

The study examined how chronic stress impacts the cardiovascular health of young adults in Puerto Rico. It found that chronic stress is associated with poorer cardiovascular health, and that resilience factors like optimism and social support can mediate this relationship. In other words, chronic stress appears to affect cardiovascular health both directly and indirectly by reducing individual resilience resources. This suggests that interventions targeting stress management and building resilience could be important for promoting cardiovascular health in this population.

Deep Dive

Technical Deep Dive: Associations between Chronic Stress, Resilience Resources, and Cardiovascular Health among Young Adults in Puerto Rico

Overview

This study examined the association between chronic stress, resilience resources, and cardiovascular health (CVH) in a large community cohort of 18-29 year olds in Puerto Rico. The key findings were:

  • High chronic stress was associated with suboptimal CVH.
  • Resilience factors like optimism and social support mediated the association between chronic stress and suboptimal CVH, accounting for 26% and 10% of the association respectively.
  • Chronic stress was associated with suboptimal CVH both directly and indirectly through lower resilience resources.

Methodology

  • Participants (n=2,676; 61.9% female) were assessed between September 2020 and March 2024.
  • CVH was measured using the American Heart Association's Life's Essential 8 (LE8) metric, which combines survey, lab, and physical exam data (range 0-100, suboptimal CVH = <80).
  • Surveys assessed chronic stress and resilience resources (optimism, religiosity, spirituality, social support).
  • Multivariable logistic regression examined the association between chronic stress and CVH, with resilience resources tested as moderators and mediators.

Results

  • High chronic stress was associated with suboptimal CVH (OR=1.46; 95% CI: 1.19, 1.80).
  • Resilience factors did not moderate the stress-CVH association.
  • However, optimism and social support mediated the stress-CVH association, accounting for 26% and 10% of the effect, respectively.

Interpretation

  • Chronic stress appears to impact CVH both directly and indirectly by reducing resilience resources like optimism and social support.
  • Interventions targeting stress management and bolstering resilience may be important for promoting cardiovascular health in young Puerto Rican adults.

Limitations & Uncertainties

  • This was a cross-sectional study, so causal relationships cannot be determined.
  • The study relied on self-reported measures of stress and resilience, which may be subject to biases.
  • It's unclear if these findings generalize to young adults in other Latino/Hispanic populations or geographic regions.

Next Steps

The authors recommend conducting longitudinal studies to better characterize the dynamic relationships between chronic stress, resilience, and cardiovascular health over time in this population.

Sources: [1] Rosal, M.C., Person, S.D., Kiefe, C.I. et al. Associations between Chronic Stress, Resilience Resources, and Cardiovascular Health among Young Adults in Puerto Rico: the PR-OUTLOOK study. medRxiv 2026.03.18.26348758; doi: https://doi.org/10.64898/2026.03.18.26348758

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