Is psycho-physical stress a risk factor for stroke? A case-control study

Author(s): Egido JA, Castillo O, Roig B, Sanz I, Herrero MR, et al.


Background:Chronic stress is associated with cardiovascular diseases, but the link with stroke has not been well established. Stress is influenced by life-style habits, personality type and anxiety levels. We sought to evaluate psycho-physical stress as a risk factor for stroke, while assessing gender influences.

Methods:Case-control study. cases: patients (n=150) aged 18-65, admitted consecutively to our Stroke Unit with the diagnosis of incident stroke.

Controls:(n=300) neighbours (paired with case ±5 years) recruited from the census registry.

Study variables:socio-demographic characteristics, vascular risk factors, psychophysical scales of H&R (Holmes & Rahe questionnaire of life events), ERCTA (recall scale of type A behaviour), SF12 (QoL scale), GHQ28 (general health questionnaire). Statistical analyses included conditional multiple logistic regression models.

Results:Mean age was 53.8 years (SD: 9.3). Compared with controls, and following adjustment for confounding variables, significant associations between stroke and stress were: H&R values >150 OR=3.84 (95% CI 1.91 to 7.70, p<0.001); ERCTA (values >24) OR=2.23 (95% CI 1.19 to 4.18, p=0.012); mental SF12 (values >50) OR=0.73 (95% CI 0.39 to 1.37, p=0.330); psychological SF12 (values >50) OR=0.66 (95% CI 0.33 to 1.30, p=0.229), male gender OR=9.33 (95% CI 4.53 to 19.22, p<0.001), high consumption of energy-providing beverages OR=2.63 (95% CI 1.30 to 5.31, p=0.007), current smoker OR=2.08 (95% CI 1.01 to 4.27, p=0.046), ex-smoker OR=2.35 (95% CI 1.07 to 5.12, p=0.032), cardiac arrhythmia OR=3.18 (95% CI 1.19 to 8.51, p=0.022) and Epworth scale (≥9) OR=2.83 (95% CI 1.03 to 7.78, p=0.044).

Conclusions:Compared with healthy age-matched individuals, stressful habits and type A behaviour are associated with high risk of stroke. This association is not modified by gender.

Similar Articles

Ageing and atherosclerosis: Mechanisms and therapeutic options

Author(s):  Costopoulos C, Liew TV, Bennett M

Age and risk for depression among the elderly: a meta-analysis of the published literature

Author(s): Zhao KX, Huang CQ, Xiao Q, Gao Y, Liu QX, et al.

Prospective study on occupational stress and risk of stroke

Author(s): Tsutsumi A, Kayaba K, Kario K, Ishikawa S

Stressful life events as triggers of ischemic stroke: a case-crossover study

Author(s): Guiraud V, Touzé E, Rouillon F, Godefroy O, Mas JL

Seismic intensity and risk of cerebrovascular stroke: 1995 Hanshin-Awaji earthquake

Author(s): Sokejima S, Nakatani Y, Kario K, Kayaba K, Minowa M, et al.

Influences of The Great Hanshin-Awaji Earthquake on glycemic control in diabetic patients

Author(s): Kirizuka K, Nishizaki H, Kohriyama K, Nukata O, Arioka Y, et al.

Socioeconomic status and stroke

Author(s): Cox AM, McKevitt C, Rudd AG, Wolfe CD

Socioeconomic status and stroke: an updated review

Author(s): Addo J, Ayerbe L, Mohan KM, Crichton S, Sheldenkar A, et al.

Depression as an antecedent to heart disease among women and men in the NHANES I study

Author(s): Ferketich AK, Schwartzbaum JA, Frid DJ, Moeschberger ML

Prospective study of depressive symptoms and risk of stroke among japanese

Author(s): Ohira T, Iso H, Satoh S, Sankai T, Tanigawa T, et al.

Depressive symptoms and risk of stroke: the Framingham Study

Author(s): Salaycik KJ, Kelly-Hayes M, Beiser A, Nguyen AH, Brady SM, et al.

Depression and incident stroke in women

Author(s): Pan A, Okereke OI, Sun Q, Logroscino G, Manson JE, et al.

Antidepressant medication use and future risk of cardiovascular disease: the Scottish Health Survey

Author(s): Wulsin L, Alwell K, Moomaw CJ, Lindsell CJ, Kleindorfer DO, et al.

Comparison of two depression measures for predicting stroke outcomes

Author(s): Wulsin L, Alwell K, Moomaw CJ, Lindsell CJ, Kleindorfer DO, et al.

Cardiac disease, depressive symptoms, and incident stroke in an elderly population

Author(s): Wouts L, Oude Voshaar RC, Bremmer MA, Buitelaar JK, Penninx BW, et al.

Social networks and incident stroke among women with suspected myocardial ischemia

Author(s): Rutledge T, Linke SE, Olson MB, Francis J, Johnson BD, et al.

Socioeconomic status and stroke incidence in the US elderly: the role of risk factors in the EPESE study

Author(s): Avendano M, Kawachi I, Van Lenthe F, Boshuizen HC, Mackenbach JP, et al.

BDNF genotype potentially modifying the association between incident stroke and depression

Author(s): Kim JM, Stewart R, Kim SW, Yang SJ, Shin IS, et al.

Psychological distress, major depressive disorder, and risk of stroke

Author(s): Surtees PG, Wainwright NW, Luben RN, Wareham NJ, Bingham SA, et al.

Does psychological distress predict the risk of ischemic stroke and transient ischemic attack? The Caerphilly Study

Author(s): May M, McCarron P, Stansfeld S, Ben-Shlomo Y, Gallacher J, et al.

Well-being and treatment satisfaction in older people with diabetes

Author(s): Petterson T, Lee P, Hollis S, Young B, Newton P, et al.