Higher Stress Tied to Worse Respiratory Outcomes With COPD

TUESDAY, May 6, 2025 (HealthDay News) — Among former smokers with chronic obstructive pulmonary disease (COPD), higher perceived stress is associated with worse respiratory outcomes, according to a study published in the March issue of Chronic Obstructive Pulmonary Diseases.

Obiageli Offor, M.D., from Johns Hopkins University in Baltimore, and colleagues evaluated the association of perceived stress with respiratory outcomes and distinct biological mechanisms among former smokers with COPD. The analysis included 99 participants of the Comparing Urban and Rural Effects of Poverty on COPD study.

The researchers found that the median Perceived Stress Scale (PSS) score was 13 across all visits through six months. There was an association between low perceived stress (PSS: 0 to 13), moderate (PSS: 14 to 26), and high perceived stress (PSS: 27 to 40) with worse respiratory health status and respiratory-related quality of life. For high perceived stress, the association exceeded clinically important differences, with only high PSS associated with increased moderate/severe exacerbations (odds ratio, 4.15). High stress was associated with lower urine thiobarbituric acid reactive substances (β = −25.5 percent) and higher 8-isoprostane (β = 40.1 percent) compared with low stress. Among individuals with mild-to-moderate COPD, moderate (β = 20.1 percent) and high (β = 52.9 percent) stress were associated with higher urine 11-dehydro-thromboxane B2 compared with low stress.

“Platelet activation, which may contribute to inflammation, and oxidative stress, which may lead to cell and tissue damage, are also impacted by increased perceived stress,” Offor said in a statement.

One author disclosed ties to the pharmaceutical industry.

Abstract/Full Text