Chronic stress associated with high stroke risk

Psycho-physical stress factors related to stressful lifestyle and type A personality are associated with stroke, according to recent study results published in the Journal of Neurology Neurosurgery and Psychiatry.

From January 2008 to December 2010, researchers compared 150 patients admitted to the stroke unit of the Hospital Clinico San Carlos with a primary diagnosis of incident stroke with 300 healthy control individuals randomly selected from that patient’s local neighborhood.

Levels of chronic stress were assessed using the combined quantitative scores of four validated scales, looking at major life events; symptoms, such as anxiety and depression; general wellbeing and behavior patterns indicative of type A personality (ERCTA scale).

Type A behaviors include hostility, aggression, impatience and a quick temper. A score of 24 or higher on the ERCTA scale was considered to be indicative of a type A personality.

Participants were also assessed for known biological risk factors for stroke, including diabetes, high blood pressure, high cholesterol, any history of heart rhythm abnormalities and daytime sleepiness.

Compared with healthy controls, the risk of a stroke was almost four times higher among those who had experienced a major life event in the previous year.  A high score on the ERCTA scale more than doubled stroke risk, as did a current or previous history of smoking and intake of two or more energy drinks a day. Those with cardiac arrythmia were more than three times as likely to have a stroke while those with a high daytime sleepiness score almost tripled their risk.

When all the factors were assessed together, researchers found the risk of stroke was associated with a stressful life and type A behaviors.

“Addressing the influence of psycho-physical factors on stroke could constitute an additional therapeutic line in the primary prevention of stroke in the at-risk population and, as such, warrants further investigation,” the researchers concluded.


Edigo JA, Castillo O, Roig B, et al. Is psycho-physical stress a risk factor for stroke? A case-control study. J Neurol Neurosrug Psychiatry. Aug. 29, 2012. [Epub ahead of print]

Disclosure: The researchers had no relevant financial disclosures.

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