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Updated: Jun 26, 2026
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Charting the perfect storm: emerging biological interfaces between stress and stroke
G Kronenberg1,2,3, J Schöner2,4,3, C Nolte4,3
1Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Rostock, Rostock, Germany.
Insights
Psychosocial stress impacts cardiovascular health, increasing risks for myocardial infarction and stroke. Understanding the biological links between stress, psychiatric disorders, and stroke is crucial for prevention and treatment.
Area of Science:
- Neuroscience
- Cardiology
- Psychiatry
Background:
- Psychosocial stress is an underestimated risk factor for cardiovascular diseases like myocardial infarction and stroke.
- Stress and psychiatric disorders can be both causes and consequences of cardiovascular disease.
- Biological mechanisms linking stress to cardiovascular morbidity include neuroendocrine dysregulation, oxidative stress, and inflammation.
Purpose of the Study:
- To map the biological interfaces between stress, psychiatric disorders, and stroke.
- To highlight the bidirectional relationship between cardiovascular disease and mental health.
- To review potential mediators and predictors of stress-related vascular morbidity and stroke outcomes.
Main Methods:
- Review of current scientific literature on stress, psychiatric disorders, and cardiovascular disease.
- Analysis of biological pathways implicated in stress-induced endothelial dysfunction.
- Examination of heart rate as a predictor of stroke outcome.
Main Results:
- Stress contributes to endothelial dysfunction through neuroendocrine, inflammatory, and oxidative pathways.
- Heart rate is a valuable, accessible measure reflecting vascular morbidity and psychological distress, and a predictor of stroke outcome.
- FK506-binding protein 51 (FKBP5) and telomere maintenance perturbations are potential mediators between stress and vascular disease.
Conclusions:
- Stress and psychiatric disorders have complex, bidirectional relationships with cardiovascular disease, particularly stroke.
- Interventions targeting biological pathways and heart rate may improve outcomes for stress-related cardiovascular conditions.
- Psychiatric sequelae of cardiovascular events significantly impact recovery, quality of life, and mortality.
Abstract:
A growing body of evidence demonstrates that psychosocial stress is an important and often underestimated risk factor for cardiovascular disease such as myocardial infarction and stroke. In this article, we map out major biological interfaces between stress, stress-related psychiatric disorders, and stroke, placing special emphasis on the fact that stress and psychiatric disorders may be both cause and consequence of cardiovascular disease. Apart from high-risk lifestyle habits such as smoking and lack of exercise, neuroendocrine dysregulation, alterations of the hemostatic system, increased oxidative stress, and inflammatory changes have been implicated in stress-related endothelial dysfunction. Heart rate provides another useful and easily available measure that reflects the complex interplay of vascular morbidity and psychological distress. Importantly, heart rate is emerging as a valuable predictor of stroke outcome and, possibly, even a target for therapeutic intervention. Furthermore, we review recent findings highlighting the role of FK506-binding protein 51 (FKBP5), a co-chaperone of the glucocorticoid receptor, and of perturbations in telomere maintenance, as potential mediators between stress and vascular morbidity. Finally, psychiatric sequelae of cardiovascular events such as post-stroke depression or posttraumatic stress disorder are highly prevalent and may, in turn, exert far-reaching effects on recovery and outcome, quality of life, recurrent ischemic events, medication adherence, and mortality.
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