Chronic stress linked to high risk of stroke

[Is psycho-physical stress a risk factor for stroke? A case-control study Online First doi 10.1136/jnnp-2012-302420]

Chronic stress, prompted by major life stressors and type A personality traits, is linked to a high risk of stroke, finds research published online in the Journal of Neurology Neurosurgery and Psychiatry.

Chronic stress, manifested as physical and/or mental symptoms in response to stressors lasting longer than 6 months has been linked to a heightened risk of heart disease. But its impact on the risk of stroke has not been clear.

The research team base their findings on150 adults, with an average age of 54, who had been admitted to one stroke unit, and 300 randomly selected healthy people of a similar age who lived in the same neighbourhood.

Levels of chronic stress were assessed using the combined quantitative scores of four validated scales, looking at major life events; symptoms, such as anxiety and depression; general wellbeing; and behaviour patterns indicative of type A personality (ERCTA scale).

Type A behaviours include hostility, aggression, impatience and a quick temper. A score of 24 or higher on the ERCTA scale is considered to be indicative of a type A personality.

Participants were also assessed for known biological risk factors for stroke, including diabetes, high blood pressure, high cholesterol, any history of heart rhythm abnormalities, and daytime sleepiness.

And they were quizzed on their lifestyle, including their caffeine, alcohol and energy drink intake, as well as whether they smoked, had a partner, and a job.

The results showed that several factors were independently associated with a heightened risk of stroke.

Compared with the healthy comparison group, the risk of a stroke was almost four times higher among those who had experienced a major life event in the previous year.

A high score on the ERCTA scale more than doubled stroke risk, as did a current or previous history of smoking, and intake of two or more energy drinks a day.

And those with heart rhythm disturbances were more than three times as likely to have a stroke while those with a high daytime sleepiness score almost tripled their risk. And being a man boosted the risk nine-fold.

But when all the factors were assessed together, the risk of a stroke was associated with a stressful life and type A behaviours. And this held true, irrespective of other risk factors, including gender and an unhealthy lifestyle.