Stroke and stress levels

 Stressed-out, type A personalities may be more likely to suffer a stroke than their mellow counterparts, a new Spanish study suggests.
Previous research has linked stress to heart disease, but this latest finding, which appears online Aug. 29 in the Journal of Neurology, Neurosurgery and Psychiatry, looked at stress in relation to stroke risk.
Researchers from the Hospital Clinico Universitario San Carlos in Madrid compared stroke risk factors, including stress levels, among 150 adults who had a stroke and 300 healthy adults (the "control" group). Stress levels were measured using standardized tools assessing major life events, anxiety and depression, general well-being and personality type. Participants also answered questions about their caffeine, alcohol and energy drink intake, smoking status and whether or not they had a job.
Having had a stressful major life event in the past year quadrupled the risk of stroke, while having a type A personality doubled the chances, according to Dr. Jose Antonio Egido and colleagues. Smoking or having smoked in the past also doubled the chances, the investigators found.
"Addressing the influence of psychophysical 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 study authors concluded.
Experts agreed the finding could help doctors better understand the effect of stress on stroke risk. But while the study did show an association between the two it did not prove cause and effect.
"This study is useful and valuable because it shows us that there is an association between stress, type A personalities and stroke risk," said Dr. Deepak Bhatt, director of the integrated cardiovascular intervention program at Brigham and Women's Hospital in Boston. "Stress can elevate blood pressure, and high blood pressure is a major risk factor for stroke."
It also makes sense that someone who is continually stressed may smoke, drink alcohol, eat an unhealthy diet and not exercise regularly, which could make things worse, Bhatt added.
Taking steps to lower stress levels may help offset these risks, he said. Exercise and meditation are two ways to help keep stress at bay. It's also important to begin to identify stress triggers and take steps to avoid them, he said. "If it is deadlines that stress you out, it may be worthwhile to set aside more time when one is pending so you are not burning the midnight oil."
Dr. Rafael Ortiz, director of the Center for Stroke and Neuro-Endovascular Surgery at Lenox Hill Hospital in New York City, said that the findings emphasize the need for tighter control of known risk factors for stroke -- especially in the face of stress.
"Make sure your high blood pressure is controlled, maintain a healthy diet and remain physically active regardless of the stress happening in your life," he said. "All this will decrease your chance of having a stroke."
Dr. Curtis Reisinger, a clinical psychologist at Zucker Hillside Hospital in Glen Oaks, N.Y., said that it is likely the anger and hostility associated with type A personalities are what contribute to cardiovascular risks.
"A lot of people don't even recognize that they are angry, but they snap all the time and are always gritting their teeth," he said. Biofeedback and cognitive behavior therapy can teach people to control how they react to events that cause them to become stressed or angry.
More information

Learn more about stroke risk factors from the U.S. Centers for Disease Control and Prevention.