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However, the long-term impact of cumulative stressful life events on the risk of myocardial infarction (MI) and mortality in the general population remains underexplored. This study investigates the association between lifetime exposure to stressful life events and the risk of non-fatal MI, MI-related mortality, and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from 21,830 participants aged\u2009\u2265\u200940 in the Troms\u00f8 Study (1994\u20132020). Exposure to stressful life events was assessed retrospectively in 2015\u20132016 and categorized into groups based on the total number of reported events. Cox proportional hazards models were used to estimate hazard ratios for non-fatal MI, MI-related mortality, and all-cause mortality, adjusting for age, sex, lifestyle, treatment, and biological factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants reporting four or more stressful life events experienced non-fatal MI on average 3.7 years earlier, MI-related mortality 12.3 years earlier, and all-cause mortality 9.5 years earlier than those without exposure to stressful life events. Higher exposure to stressful life events was associated with increased risk of non-fatal MI (hazard ratio 1.06 per additional event; 95% confidence interval: 1.01\u20131.10), MI-related mortality (hazard ratio 1.25; 95% confidence interval: 1.07\u20131.46), and all-cause mortality (hazard ratio 1.14; 95% confidence interval: 1.08\u20131.20). These associations persisted after adjustment for traditional cardiovascular risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lifetime exposure to stressful life events is associated with risks of MI, MI-related mortality, and all-cause mortality. Our findings highlight the importance of considering psychosocial stress in cardiovascular risk assessments and support the integration of screening for stressful life events into preventive cardiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-025-05269-4","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T09:54:38Z","timestamp":1766570078000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Investigating the association between stressful life events and the risk of myocardial infarction and mortality: the Troms\u00f8 study"],"prefix":"10.1186","volume":"25","author":[{"given":"Geir Fagerjord","family":"Lorem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjersti","family":"Lillevoll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja-Lisa","family":"L\u00f8chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Wilsgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens C.","family":"Thimm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina Elisabeth Arfwedson","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Schirmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"issue":"34","key":"5269_CR1","doi-asserted-by":"publisher","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","volume":"42","author":"FL Visseren","year":"2021","unstructured":"Visseren FL, Mach F, Smulders YM, Carballo D, Koskinas KC, B\u00e4ck M, et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice: developed by the task force for cardiovascular disease prevention in clinical practice with representatives of the European society of cardiology and 12 medical societies with the special contribution of the European association of preventive cardiology (EAPC). 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We received approval from the Norwegian Data Inspectorate and the Regional Committee for Medical and Health Research Ethics for Northern Norway (REC-North #199331). The Troms\u00f8 Study adheres to the ethical principles outlined in the Declaration of Helsinki. Written informed consent was obtained from all participants, and the publication committee of the Troms\u00f8 Study approved this specific project. In adherence to best practices for cohort reporting, this study follows the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"874"}}