The Association Between Cardiovascular Risk Factors and Emotional States: A Summary of the Tehran Lipid and Glucose Study

Abstract

Context: The current study aimed to review the studies that investigated the association of cardiovascular risks and emotional states in men and women participating in the Tehran Lipid and Glucose Study (TLGS). Evidence Acquisition: A comprehensive search of PubMed, Scopus, and Web of Science was conducted to identify cross-sectional and prospective studies published through February 2026, based on predetermined inclusion and exclusion criteria. Cardiovascular risk factors were defined as weight status, blood pressure, and insulin resistance, while emotional states encompassed depression, anxiety, and stress. Given the heterogeneity in study designs and outcomes, the findings were synthesized narratively, and a meta-analysis was not performed. Results: Six eligible studies (four cross-sectional and two prospective) were included. Their findings indicated that hypertension and insulin resistance were associated with increased emotional distress, particularly among women with diagnosed hypertension. Long-term weight analyses showed that higher stress levels in males were associated with progression to overweight and obesity from childhood. Severe obesity was associated with greater mental distress in both sexes. Studies on obesity phenotypes indicated that higher anxiety and stress scores were observed among metabolically unhealthy obese women, a pattern also observed in metabolically unhealthy men regardless of weight status. Conclusions: Evidence from the TLGS indicated a sex-dependent association between cardiovascular risks and emotional states, with a significant association observed specifically in women.