International Journal of Behavioral Medicine

, Volume 21, Issue 5, pp 821–832 | Cite as

Gender-Specific Associations of Perceived Stress and Coping Strategies with C-Reactive Protein in Middle-Aged and Older Men and Women

  • Chisato ShimanoeEmail author
  • Yasuko Otsuka
  • Megumi Hara
  • Hinako Nanri
  • Yuichiro Nishida
  • Kazuyo Nakamura
  • Yasuki Higaki
  • Takeshi Imaizumi
  • Naoto Taguchi
  • Tatsuhiko Sakamoto
  • Mikako Horita
  • Koichi Shinchi
  • Keitaro Tanaka



Perceived stress and coping strategies may influence the risk of cardiovascular disease through their possible association with inflammation, but data remain controversial for perceived stress or scanty for coping strategies.


We examined the associations of perceived stress and coping strategies with serum high-sensitivity C-reactive protein (CRP) in a Japanese general population.


This cross-sectional study included 2,971 men and 4,902 women aged 40–69 years who were enrolled between 2005 and 2007. Subjects with possible inflammation-related disease, CRP levels ≥3,000 ng/mL, or currently used analgesics or lipid-lowering drugs were excluded. Analyses were performed by gender with adjustment for lifestyle, socioeconomic, and psychosocial factors.


Unexpectedly, elevated perceived stress was significantly associated with lower CRP levels in men (P trend < 0.001) but not in women (P trend = 0.90) after adjustment for age and covariates. Among five items of coping strategies evaluated, “disengagement” showed a significant inverse association with CRP in men only (P trend = 0.027). In addition, a possible interaction between “emotional support seeking” and perceived stress on CRP was detected in men (P interaction = 0.021); “emotional support seeking” was associated with lower CRP at the high stress level only (P trend = 0.028).


Both perceived stress and coping strategies may be associated with systemic inflammation in Japanese men, yet caution must be exercised before accepting the stress–inflammation–disease pathway.


Coping strategy C-reactive protein Disengagement Perceived stress 



This work was supported by Grants-in-Aid for Scientific Research on the Special Priority Areas of Cancer (no. 17015018) and Innovative Areas (no. 221S0001), Scientific Research (a) no. 20249038 and (b) no. 18390182, and Young Scientists (a) no. 20689014 and (b) no. 18790380 from the Ministry of Education, Culture, Sports, Science and Technology, Japan. The authors thank Dr. Monji Akira at the Department of Psychiatry, Faculty of Medicine, Saga University, for his critical reading of this manuscript.

Conflict of Interest

All authors declare that they have no conflicting interests.


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Copyright information

© International Society of Behavioral Medicine 2013

Authors and Affiliations

  • Chisato Shimanoe
    • 1
    Email author
  • Yasuko Otsuka
    • 1
  • Megumi Hara
    • 1
  • Hinako Nanri
    • 1
  • Yuichiro Nishida
    • 1
  • Kazuyo Nakamura
    • 2
  • Yasuki Higaki
    • 3
  • Takeshi Imaizumi
    • 1
  • Naoto Taguchi
    • 1
  • Tatsuhiko Sakamoto
    • 4
  • Mikako Horita
    • 1
  • Koichi Shinchi
    • 5
  • Keitaro Tanaka
    • 1
  1. 1.Department of Preventive Medicine, Faculty of MedicineSaga UniversitySagaJapan
  2. 2.St. Mary’s College Faculty of NursingKurumeJapan
  3. 3.Faculty of Sports and Health ScienceFukuoka UniversityFukuokaJapan
  4. 4.Department of ManagementFukuoka Institute of Health and Environmental SciencesDazaifuJapan
  5. 5.Division of International Health and Nursing, Faculty of MedicineSaga UniversitySagaJapan

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