Middle-aged and older adults who suffer from high levels of stress, hostility, or depression are at greater risk for stroke or transient ischemic attack (a stroke caused by a temporary blockage of blood flow to the brain), according to new research published in the journal Stroke.
Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), an ongoing study on cardiovascular disease risk factors, researchers investigated whether psychological factors could influence risk for chronic disease.
The data included more than 6,700 adults (ages 45-84; 53 percent women) who reported their chronic stress levels, depressive symptoms, anger, and hostility over a two-year period. Participants were 38.5 percent white, 27.8 percent African-American, 11.8 percent Chinese, and 21.9 percent Hispanic. All were free of cardiovascular disease at the start of the study.
During follow-up 8.5 to 11 years later, 147 strokes and 48 TIAs occurred. Compared to people with the lowest psychological scores, those with highest scores were:
- 86 percent more likely to have a stroke or TIA for high depressive symptoms;
- 59 percent more likely to have a stroke or TIA for the highest chronic stress scores;
- more than twice as likely to have a stroke or TIA for the highest hostility scores;
- no significant increased risk was linked to anger.
“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,” said lead author Susan Everson-Rose, Ph.D., M.P.H., associate professor of medicine at the University of Minnesota in Minneapolis.
“Given our aging population, it’s important to consider these other factors that might play a role in disease risk. Stroke is a disease of the elderly predominantly, and so learning more about things that can influence risk for stroke as people age is important.”
Researchers measured chronic stress in five domains: personal health problems, health problems of others close to the participant, job or ability to work, relationships, and finances.
Depressive symptoms were measured with a 20-question scale and anger was measured with a 10-item scale that captured the extent and frequency of experiencing that emotion. Hostility was measured by assessing a person’s cynical expectations of other people’s motives.
“One thing we didn’t assess is coping strategies,” Everson-Rose said. “If someone is experiencing depressive symptoms or feeling a lot of stress or hostility, we don’t know how they manage those, so it’s possible that positive coping strategies could ameliorate some of these associations or effects.”
Source: American Heart Association