Stress linked to ischemic strokes

Oct 1 2009

Strong links have been uncovered between stress and ischemic strokes. Researchers writing in the open access journal BMC Medicine have carried out the first study into the correlation between self-reported feelings of prolonged psychological stress and different stroke subtypes.

The research, undertaken by Katarina Jood and her team at the University of Gothenburg, clarifies the ties between stress and strokes. Jood said, "We found an independent association between self-perceived psychological stress and ischemic stroke. A novel finding was that this association differed by ischemic stroke subtype".

566 acute stroke patients and 593 controls were asked to rate their stress levels on a 6-point sliding scale from 'never stressed' to 'permanently stressed for the past 5 years'. The patients were split into stressed (permanent stress for 1 year or greater) and non-stressed (never stressed or infrequent periods of stress) groups. When this was compared with stroke incidence and the type, there was a strong correlation between prolonged stress and large vessel disease, small vessel disease and cryptogenic stroke.

"Our results should be interpreted with caution as the case-control-design may lead to an overestimation of stress as a risk factor for stroke. However, the study contributes with important indications that the association between stress and stroke may differ between different stroke subtypes, and it calls for further prospective studies of the relation between stress and stroke", says Jood. Stress may be related to behaviours associated with an increased susceptibility for stroke, such as smoking, physical inactivity, and socioeconomic status. Moreover, frequent or persistent activation of the sympathetic nervous system, the hypothalamus as well as pituitary and adrenal glands may also lead to hypertension and/or metabolic disturbances that could lead to strokes. Strokes are currently one of the biggest killers in the world, causing 9.7% of deaths according to the World Health Organisation, so knowledge of their causation is vital.