Psychological strains, salivary biomarkers, and risks for coronary heart disease among hurricane survivors

Biol Res Nurs. 2015 May;17(3):311-20. doi: 10.1177/1099800414551164. Epub 2014 Sep 18.


Objective: To examine the associations of psychological strains, salivary biomarkers, and coronary heart disease (CHD) risks in hurricane survivors 2 years after Hurricane Ike in the United States.

Background: Hurricane survivors often suffer from long-lasting posttraumatic stress disorder (PTSD) and other forms of psychological strain related to surviving a natural disaster and dealing with its aftermath. Psychological strains may be associated with biomarkers, which, in turn, may be associated with a higher incidence of CHD risks.

Methods: Structured interviews were conducted with 19 hurricane survivors to assess psychological strains (PTSD, perceived stress, depression, and anxiety) and measure CHD risks. Saliva samples were collected by the passive drool method and analyzed for inflammatory cytokine (interleukin [IL]-1β, IL-6, and IL-10) and chemokine (monocyte chemotactic protein [MCP]-1) biomarkers.

Results: The salivary level of MCP-1 was significantly associated with PTSD symptoms, depression (both p < .01), and anxiety (p < .05). There were significant associations between anxiety and hypertension (p < .01), perceived stress and blood glucose level (p < .05), and perceived stress and obesity (p < .05).

Conclusion: Our findings that long-lasting psychological strains are associated with major CHD risks and salivary MCP-1 levels suggest that the mechanism by which such strains play a role in the development of CHD involves recruitment of monocyte cells in response to chronic endothelial inflammation. Further studies are needed to advance our understanding of the underlying mechanisms by which the PTSD and other psychological strains contribute to the development of CHD.

Keywords: anxiety; coronary heart disease; depression; perceived stress; posttraumatic stress disorder (PTSD); salivary MCP-1; salivary cytokines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / analysis*
  • Coronary Disease / etiology*
  • Cyclonic Storms*
  • Female
  • Humans
  • Interleukin-10 / analysis
  • Interleukin-1beta / analysis
  • Interleukin-6 / analysis
  • Interviews as Topic
  • Male
  • Middle Aged
  • Monocyte Chemoattractant Proteins / analysis
  • Peptide Fragments / analysis
  • Risk Factors
  • Saliva / chemistry*
  • Stress Disorders, Post-Traumatic / complications
  • Stress, Psychological / complications*


  • Biomarkers
  • Interleukin-1beta
  • Interleukin-6
  • Monocyte Chemoattractant Proteins
  • Peptide Fragments
  • interleukin-1beta (163-171)
  • Interleukin-10