Stress, hostility, and depressive symptoms appear to increase the risk of stroke and transient ischemic attack in middle-aged and older adults, according to findings from the Multi-Ethnic Study of Atherosclerosis (MESA).
In 6,749 adults aged 45-84 years in MESA, a longitudinal population-based cohort study, 195 incident events –147 strokes and 48 TIAs – occurred during a median follow-up of 8.5 years.
Courtesy American Heart Association
Stress and negative emotions may increase the risk of stroke and transient ischemic attack in middle-aged and older adults.
After adjustment for age, demographics, and site, the risk was greatest among those with the highest vs. lowest scores for depressive symptoms (hazard ratio, 1.86), chronic stress (HR, 1.59), and hostility (HR, 2.22). Each additional point on the depression, stress, and hostility scales was associated with increased stroke risk after researchers controlled for race, sex, age, education, and site, reported Susan Everson-Rose, Ph.D., of the University of Minnesota, Minneapolis.
The report was published online July 10 in Stroke.
The risk was attenuated but remained significant in models that adjusted for traditional stroke risk factors, inflammatory markers, and subclinical atherosclerosis, wrote Dr. Everson-Rose and her colleagues (Stroke 2014 July 10 [doi:10/1161/STROKEAHA.114.004815).
The findings highlight the importance of considering nontraditional risk factors when assessing patients for stroke and TIA risk, the investigators concluded, adding that "better understanding of important, potentially modifiable stroke risk factors, including stress and negative emotions, is needed given the aging population and increasing burden of stroke."
MESA was supported by the National Heart, Lung, and Blood Institute and by grants from the National Center for Research Resources. Dr Everson-Rose received support from the NHLBI and the Applied Clinical Research Program and Program in Health Disparities Research at the University of Minnesota. Dr. Diez Roux was supported in part by the Michigan Center for Integrative Approaches to Health Disparities.