Cardiorespiratory fitness attenuates the association between psychosocial stress and cardiometabolic risk - Results from the SCAPIS population.

Individuals reporting high psychosocial stress had significantly lower cardiorespiratory fitness than those reporting low stress.

• High-stress individuals had lower CRF by 1.7 ml/min/kg (p < .001).
• CRF was estimated using submaximal cycle testing in ml/min/kg.
• Psychosocial stress was measured using a single self-reported item dichotomised into 'low' and 'high'.
• The sample included 4,207 healthy, middle-aged participants from the Swedish CArdioPulmonary bioImage Study (SCAPIS), conducted 2013-2018.

Individuals reporting high psychosocial stress had less favourable cardiometabolic profiles compared to those with low stress.

• Ten cardiometabolic outcomes were assessed, including waist circumference, BMI, and blood pressure.
• Cross-sectional associations were analysed using t-tests and multiple linear regression.
• Participants were healthy and middle-aged, drawn from a population-based cohort.

Cardiorespiratory fitness moderated the relationship between psychosocial stress and waist circumference, BMI, systolic blood pressure, and diastolic blood pressure.

• For each 1 ml/min/kg higher CRF, the stress-related association was reduced by 0.17 cm in waist circumference (p < .001).
• For each 1 ml/min/kg higher CRF, the stress-related association was reduced by 0.06 kg/m2 in BMI (p < .001).
• For each 1 ml/min/kg higher CRF, the stress-related association was reduced by 0.18 mmHg in systolic blood pressure (p = .030).
• For each 1 ml/min/kg higher CRF, the stress-related association was reduced by 0.13 mmHg in diastolic blood pressure (p = .020).

Associations between CRF and cardiometabolic risk were stronger among individuals in the high-stress group.

• Associations were 13-25% stronger in the high-stress group compared to the low-stress group.
• This pattern was observed across cardiometabolic outcomes including waist circumference, BMI, and blood pressure measures.
• The study used multiple linear regression to examine moderation effects.

The study was cross-sectional in design, limiting causal inference between CRF, stress, and cardiometabolic outcomes.

• Data were drawn from SCAPIS, conducted between 2013 and 2018.
• The sample included 4,207 healthy, middle-aged participants.
• Psychosocial stress was measured with a single self-reported item, which may limit the precision of stress assessment.
• Cross-sectional design precludes conclusions about the direction of associations between CRF, stress, and cardiometabolic risk.