Self-reported stress linked with fatal stroke; unhealthy habits may be factor

March 13, 2003

DALLAS, March 14 - People who said they were highly stressed had a higher risk of fatal stroke than people who said they were stress-free, according to a report in today's rapid access issue of Stroke: Journal of the American Heart Association.

Researchers say the link may be due to the stressed people having cardiovascular risk factors. They tended to smoke, be less physically active, drink more alcohol and be treated for high blood pressure.

Because stress was associated with so many unhealthy behaviors, researchers couldn't determine if self-reported stress was an independent risk factor.

People who said they had high stress levels had almost double the risk of fatal stroke. Those who said they felt stress on a weekly basis had a 50 percent increased risk of a fatal stroke compared to those in the least stressed groups. Researchers found no significant effect of stress on nonfatal strokes.

There are several possible explanations why stress may be associated with only a higher risk of fatal stroke, says the study's lead author, Thomas Truelsen M.D., Ph.D., from the department of neurology, Bispebjerg Hospital and the Institute of Preventive Medicine, Copenhagen, Denmark.

"This group of stroke patients may have more severe strokes, have a more complicated rehabilitation period, or some unknown biological mechanism may be important."

Researchers used data from The Copenhagen City Heart Study (CCHS), a prospective study examining 5,604 men and 6,970 women. From 1981 to 1983, participants were asked about the intensity and frequency of their stress. They were asked to report their stress intensity as never/hardly ever, light, moderate or high. They were asked to report their stress frequency as never/hardly ever, monthly, weekly or daily. Stress was defined as the sensation of tension, nervousness, impatience, anxiety or sleeplessness.

Truelson says the questions reflected chronic stress rather than acute stress situations.

In 13 years of follow-up, 929 of all participants had a first-ever stroke; 207 (22 percent) were fatal within 28 days of onset. Of the 716 people who reported high stress, 59 (8 percent) had strokes. Eighteen people (2.5 percent) who reported high stress had fatal strokes. Researchers found that the risk of fatal stroke was 89 percent higher for those who reported a high level of stress compared to those who reported never or hardly ever having stress.

He suggests looking beyond stress to reduce fatal stroke risk.

"Both the person feeling stressed and the physician being consulted should try not only to discuss stress but also stroke risk factors and what can be done to reduce them," he says.

"Lay people often mention stress as one of the most important risk factors for stroke, often before well-established stroke risk factors such as hypertension and smoking," he says. "The scientific literature is inconclusive. Although stress is often mentioned, there is little agreement on what it actually means or how it should be measured."
Co-authors are Naja Nielsen, B.Msc.; Gudrun Boysen, M.D., D.M.Sc.; and Morten Grønbaek, M.D., D.M.Sc.

NR03-1037 (Stroke/Truelsen)

CONTACT: For journal copies only,
please call: 214-706-1396
For other information, call:
Carole Bullock: 214-706-1279
Bridgette McNeill: 214-706-1135

American Heart Association

Related Stress Articles from Brightsurf:

Stress-free gel
Researchers at The University of Tokyo studied a new mechanism of gelation using colloidal particles.

Early life stress is associated with youth-onset depression for some types of stress but not others
Examining the association between eight different types of early life stress (ELS) and youth-onset depression, a study in JAACAP, published by Elsevier, reports that individuals exposed to ELS were more likely to develop a major depressive disorder (MDD) in childhood or adolescence than individuals who had not been exposed to ELS.

Red light for stress
Researchers from the Institute of Industrial Science at The University of Tokyo have created a biphasic luminescent material that changes color when exposed to mechanical stress.

How do our cells respond to stress?
Molecular biologists reverse-engineer a complex cellular structure that is associated with neurodegenerative diseases such as ALS

How stress remodels the brain
Stress restructures the brain by halting the production of crucial ion channel proteins, according to research in mice recently published in JNeurosci.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

How plants handle stress
Plants get stressed too. Drought or too much salt disrupt their physiology.

Stress in the powerhouse of the cell
University of Freiburg researchers discover a new principle -- how cells protect themselves from mitochondrial defects.

Measuring stress around cells
Tissues and organs in the human body are shaped through forces generated by cells, that push and pull, to ''sculpt'' biological structures.

Cellular stress at the movies
For the first time, biological imaging experts have used a custom fluorescence microscope and a novel antibody tagging tool to watch living cells undergoing stress.

Read More: Stress News and Stress Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to