The effects of stress on stroke.

Date:

07-Jan-2002

Source

Stroke

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Article

The term "stroke" or "paralytic stroke" is commonly used to describe a sudden problem with the brain that is usually related to its blood supply. A "stroke," therefore, can be due to ischemia (decreased blood supply), infarction (interrupted blood supply), or hemorrhage (severe bleeding), and usually means that there is some kind of permanent problem with the nervous system.1 All three of these causes (ischemia, infarction, or hemorrhage) would be due to cerebrovascular disease (disease related to the blood supply to the brain).

Cerebrovascular disease is divided into two broad categories: thrombotic and embolic. Thrombotic strokes occur without warning symptoms in 80-90 percent of patients. They often occur with symptoms that start and stop, and then worsen over several minutes or hours. Embolic strokes have symptoms that are at their maximum when the stroke occurs.

While many risk factors have been identified that increases a person's risk for stroke, hypertension (high blood pressure), is by far, the greatest. Other groups considered at higher risk for stroke include those with sickle cell disease, and middle-aged male patients with a history of stroke on their mother's side of the family. Patients with increased blood thickness are also considered at higher risk for stroke.

In the recent issue of the journal Stroke, published by the American Heart Association, researchers stated that psychological stress is a common factor after a stroke. Little research has investigated whether stress leads to an increased possibility of stroke. In this study, a total of 2,201 men aged 45 to 59 years were given the General Health Questionnaire (GHQ) to measure their stress levels. The occurrence of fatal and non-fatal stroke as well as transient ischemic attack, were also determined. 22% of the men surveyed had psychological stress, according to the GHQ, and there were 130 incidents of stroke, 17 being fatal. There was an increased relative risk of fatal stroke for the men who illustrated stress compared to the men who did not show stress. After being adjusted for factors such as smoking, blood pressure, and body mass index among others, the results did not change. Further adjustments for health conditions such as diabetes, lessened the relative risk, but not by a significant amount. The authors concluded that stress might be a predictor for fatal stroke but not nonfatal stroke.2

References

1. Welty TE. Cerebrovascular Disease, In: Koda-Kimble MA, Young LY, eds. Applied Therapeutics. 5th ed. Vancouver, WA: 1992;14:1-7.
2. May M. Does Psychological Distress Predict the Risk of Ischemic Stroke and Transient Ischemic Attack? Stroke. Jan 2002;33:7.