Increased Stroke Risk With Stress, Hostility, Depression
Correlations seen in middle-aged and older adults, even after adjustment for risk factors
WEDNESDAY, July 16, 2014 (HealthDay News) -- For middle-aged and older adults, stress, hostility, and depressive symptoms are associated with increased risk of incident stroke and transient ischemic attack, according to a study published online July 10 in Stroke.
Susan A. Everson-Rose, Ph.D., M.P.H., from the University of Minnesota in Minneapolis, and colleagues analyzed data from the Multi-Ethnic Study of Atherosclerosis involving 6,749 adults, aged 45 to 84 years, conducted at six U.S. sites. Standard questionnaires were used to assess chronic stress, depressive symptoms, trait anger, and hostility, and their correlation with incident stroke and transient ischemic attacks was assessed.
During a median follow-up of 8.5 years there were 195 incident events (147 strokes and 48 transient ischemic attacks). The researchers observed a gradient of increasing risk for depressive symptoms, chronic stress, and hostility (all P for trend ≤ 0.02), but no increasing risk for trait anger (P > 0.10). After adjustment for age, demographics, and site, for the highest scoring versus the lowest scoring group, risk was significantly elevated for depressive symptoms (hazard ratio, 1.86), chronic stress (hazard ratio, 1.59), and hostility (hazard ratio, 2.22). In risk factor-adjusted models, hazard ratios were attenuated but still significant. In models limited to stroke and in secondary analyses using time-varying variables, associations were similar.
"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 authors write.