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Psychosocial Stress and Risk for Intracerebral Hemorrhage in the ERICH (Ethnic/Racial Variations of Intracerebral

Tyler P Behymer1, Padmini Sekar1, Stacie L Demel1

  • 1Department of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati OH USA.

Journal of the American Heart Association
|March 7, 2025
PubMed

Insights

Psychosocial stress is a significant risk factor for intracerebral hemorrhage (ICH), even after accounting for hypertension. Specific stressors disproportionately impact Black and Hispanic individuals, highlighting a need for targeted interventions.

Area of Science:

  • Neurology
  • Public Health
  • Psychiatry

Background:

  • Intracerebral hemorrhage (ICH) has high mortality and disability rates.
  • Psychosocial stressors are linked to hypertension and stroke.
  • Racial and ethnic disparities in stress levels are documented.

Purpose of the Study:

  • To determine if psychosocial stress predicts ICH risk, controlling for known factors.
  • To investigate if hypertension mediates the stress-ICH association.
  • To examine racial/ethnic differences in stress-related ICH risk.

Main Methods:

  • Prospective, multicenter, case-control study (ERICH study).
  • Included White, Black, and Hispanic patients with matched controls.
  • Assessed four stress subtypes (financial, health, emotional, family) using a 0-10 scale.
  • Employed logistic regression and mediation analyses.

Main Results:

  • All stress subtypes were associated with increased ICH probability.
  • Financial stress linked to nonlobar ICH, disproportionately affecting Black and Hispanic patients.
  • Hypertension mediated the ICH risk from health, emotional well-being, and family stress.

Conclusions:

  • Psychosocial stress is an independent risk factor for ICH.
  • Novel mechanisms require further investigation for ICH risk mitigation.
  • Findings suggest new targets for preventing intracerebral hemorrhage.
Abstract

Keywords:
hemorrhagic strokerisk factorstressstroke management

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