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Is psycho-physical stress a risk factor for stroke? A case-control study.

Jose Antonio Egido1, Olga Castillo, Beatriz Roig

  • 1Department of Neurology, Hospital Clinico Universitario San Carlos, Avda/ Martin Lagos, s/n. 28040 Madrid, Spain. jegidoh@yahoo.com

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High stress levels and Type A behavior significantly increase stroke risk. These factors, along with smoking and certain health conditions, are key indicators for stroke prevention. Gender did not modify this association.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Psychology

Background:

  • Chronic stress is linked to cardiovascular diseases, but its specific association with stroke requires further elucidation.
  • Stress is influenced by lifestyle, personality, and anxiety, highlighting the need to explore psycho-physical stress as a stroke risk factor.
  • Investigating gender influences on the stress-stroke relationship is crucial for comprehensive risk assessment.

Purpose of the Study:

  • To evaluate psycho-physical stress as a risk factor for incident stroke.
  • To assess the influence of gender on the relationship between stress and stroke.
  • To identify specific stress-related factors and lifestyle habits associated with stroke risk.

Main Methods:

  • A case-control study was conducted with 150 incident stroke patients (ages 18-65) and 300 age-matched controls.
  • Data collected included socio-demographics, vascular risk factors, and psychophysical scales: Holmes & Rahe (H&R), ERCTA (Type A behavior), SF12 (QoL), and GHQ28 (general health).
  • Conditional multiple logistic regression models were used for statistical analysis.

Main Results:

  • High Holmes & Rahe (H&R) scores (>150) and ERCTA Type A behavior scores (>24) were significantly associated with increased stroke risk (OR=3.84 and OR=2.23, respectively).
  • Male gender, current or former smoking, high consumption of energy drinks, cardiac arrhythmia, and high Epworth scale scores (≥9) were also significant risk factors for stroke.
  • No significant association was found between stroke and SF12 mental or psychological scores.

Conclusions:

  • Stressful life events (high H&R) and Type A personality traits (ERCTA) are significant risk factors for stroke.
  • Lifestyle factors including smoking and high energy drink consumption, alongside cardiac arrhythmia, contribute to stroke risk.
  • The study found that gender does not modify the association between psycho-physical stress and stroke risk.