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Self-perceived psychological stress and ischemic stroke: a case-control study.

Katarina Jood1, Petra Redfors, Annika Rosengren

  • 1Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Göteborg, Göteborg, Sweden. katarina.jood@neuro.gu.se

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Psychological stress is linked to ischemic stroke, particularly subtypes like large vessel disease and cryptogenic stroke. Further research is needed to confirm stress as a risk factor for stroke.

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Area of Science:

  • Neurology
  • Psychiatry
  • Epidemiology

Background:

  • Psychological stress is a known contributor to coronary artery disease.
  • The relationship between psychological stress and stroke remains less understood.
  • Previous research linked self-perceived stress to myocardial infarction.

Purpose of the Study:

  • To investigate the association between self-perceived psychological stress and ischemic stroke.
  • To explore if this association varies by ischemic stroke subtype.

Main Methods:

  • A case-control study involving 600 acute ischemic stroke patients and 600 controls (aged 18-69).
  • Ischemic stroke subtypes were classified using Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.
  • Self-perceived psychological stress was assessed retrospectively via a single-item questionnaire.

Main Results:

  • Permanent psychological stress was independently associated with overall ischemic stroke (OR 3.49).
  • The association was significant for large vessel disease (OR 3.91), small vessel disease (OR 3.20), and cryptogenic stroke (OR 4.03).
  • No significant association was found for cardioembolic stroke (OR 1.48).

Conclusions:

  • Self-perceived psychological stress is independently associated with ischemic stroke.
  • The association between stress and ischemic stroke differs across stroke subtypes.
  • Further prospective studies are recommended to explore psychological stress as a potential stroke risk factor, considering stroke subtypes.