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Stress, depression, and hostility raise risk of stroke

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It pays to take things positively and avoid too much stress. People who are psychologically healthy are not only happier, they are also less likely to experience unwanted health conditions, which could lead to serious consequences such as paralysis, vision problems and even premature death.

A new study found evidence that middle aged and older adults who experience hostility, high levels of stress and depression have increased risk for stroke, one of the leading causes of adult disability and death in the U.S.

For the study published in the journal Stroke on July 10, Susan Everson-Rose, from the University of Minnesota, and colleagues followed more than 6,700 adults between 45 to 84 years old using data from the Multi-Ethnic Study of Atherosclerosis, or MESA, a population-based study from across six sites in the U.S. on the risk factors of cardiovascular disease.

None of the participants was diagnosed of cardiovascular disease when the study started but 8.5 to 11 years later, 147 of the participants had stroke and 48 had transient ischemic attack (TIA), also known as mini-stroke, which happens when the blood flow to the brain is temporarily blocked. TIA serves as a warning for a more serious stroke.

The researchers wrote that negative emotions and stress activate the hypothalamic-pituitary-adrenal axis, which plays a role in controlling reactions to stress and this activation has an influence on blood clotting.

The researchers found that those who had the highest psychological scores based on results of completed questionnaires on chronic stress, depression, anger and hostility were 85 percent more at risk to have stroke or TIA when depressed compared with the participants with the lowest psychological scores. They also had 59 percent increased risks for stroke or TIA when they experience prolonged and continuous stress and increased their likelihood for stroke or TIA by more than twice in the face of hostility.

"Higher levels of stress, hostility, and depressive symptoms are associated with significantly increased risk of incident stroke or transient ischemic attacks in middle-aged and older adults," the researchers wrote.

Everson-Rose and colleagues also looked at the participants' age, race, sex, health behavior and other risk factors of stroke and found that the association between stress, hostility, depression and stroke remains significant.

"There's such a focus on traditional risk factors - cholesterol levels, blood pressure, smoking and so forth - and those are all very important, but studies like this one show that psychological characteristics are equally important," Everson-Rose said.

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