Psychological distress, but not depression, may increase stroke risk, according to a study published in the March 4 issue of Neurology. Although previous trials had found that stroke can often lead to depression, results were mixed as to whether depression could lead to stroke.
"Understanding the mechanisms by which overall emotional health may increase stroke risk may inform stroke prevention and help identify those at increased stroke risk," said lead author Paul Surtees, PhD, a psychologist at the University of Cambridge in the United Kingdom.
Risk for Stroke and Mental Well-Being in a European Population
In the UK European Prospective Investigation into Cancer–Norfolk study, Dr. Surtees and colleagues studied 20,627 people with no history of stroke (ages 41 to 80) for an average of 8.5 years. Participants were assessed for major depressive disorder and for mental well-being with the use of the Mental Health Inventory 5. During the study, 595 participants had a stroke, 28% percent of which were fatal.
The researchers found that psychological distress was associated with an increased risk of stroke, and the risk of stroke increased with the more distress that the participants reported. The association remained the same regardless of cigarette smoking, systolic blood pressure, overall blood cholesterol, obesity, previous heart attack, diabetes, social class, education, high blood pressure treatment, family history of stroke, and recent antidepressant medication use. "This association was consistent for men and for women, for fatal and nonfatal stroke, and conformed to a dose-response relationship," noted the investigators.
For every SD point lower that participants scored on the mental health scale, their risk of stroke increased by 11%. The relationship was even more pronounced for those with fatal strokes. In addition, the researchers found that the risk of stroke was not increased for persons who had experienced an episode of major depression in the past year or for those who had experienced major depression at any point in their lifetime.