Psychological distress associated with higher risk of death from stroke

Canadian Medical Association JournalJun 19 2012

Psychological distress was associated with a higher risk of death from stroke, according to a study published in CMAJ (Canadian Medical Association Journal).

Psychological distress includes factors such as anxiety, depression, sleeping problems and loss of confidence, and is common in approximately 15%-20% of the general population.

Although there is evidence linking psychological distress to coronary artery disease, there is a dearth of data linking psychological distress with the risk of death from stroke and other cerebrovascular diseases.

Researchers from UCL (University College London), United Kingdom, sought to understand this link and looked at data from a large study of 68 652 men and women who participated in the Health Survey for England. The mean age of participants was 54.9 years, 45.0% were male and 96.1% were white.

To measure psychological distress, the researchers used the General Health Questionnaire (GHQ-12), a widely used measure in population studies. Psychological distress was evident in 14.7% of participants, and those reporting distress were younger and more likely to be female, to be from lower income groups, to smoke and to use hypertension medications. Over an average of 8.1 years' follow-up, there were 2367 deaths from cardiovascular disease (1010 from ischemic heart disease, 562 from cerebrovascular disease and 795 from other cardiovascular-related deaths.)

"Psychological distress was associated with death from cardiovascular disease, and the relation remained consistent for specific disease outcomes, including ischemic heart disease and cerebrovascular disease," writes Dr. Mark Hamer, Department of Epidemiology and Public Health, UCL, with coauthors.

"We saw an association between psychological distress and risk of cerebrovascular disease among our participants, all of whom had been free from cardiovascular disease at baseline," state the authors. "This association was similar in size to the association between psychological distress and ischemic heart disease in the same group."

The researchers suggest that questionnaires could be useful screening tools for common mental illnesses to help reduce risk factors for death from cardiovascular disease.