People who experience high levels of hostility, stress and depression are at an elevated risk of suffering a stroke, a new study finds.
The association is stronger among middle-aged and older adults. For this project, researchers used data from an ongoing study on cardiovascular disease risk factors in people living in six U.S. cities. The study included over 6,700 adults aged between 45 and 84. About 53 percent of these participants were women. Participants were 38.5 percent white, 27.8 percent African-American, 21.9 percent Hispanic and 11.8 percent Chinese. None of them had cardiovascular disease when the study began. All the participants were asked to complete questionnaires, which recorded chronic stress, depression, anger and hostility over two years.
The participants were followed for another 8.5 to 11 years. During this period, 147 strokes and 48 TIAs were recorded.
After referring to the data collected from the questionnaires, researchers found that those reporting high levels of depression were 86 percent more likely to suffer a stroke or TIA. The risk was 59 percent more among those that reported high levels of chronic stress and almost double among those with high hostility levels. No such association was found in people that reported high levels of anger.
"There's such a focus on traditional risk factors - cholesterol levels, blood pressure, smoking and so forth - and those are all very important, but studies like this one show that psychological characteristics are equally important," said Susan Everson-Rose, Ph.D., M.P.H., lead author of the study and associate professor of medicine at the University of Minnesota in Minneapolis, in a press statement. "Given our aging population, it's important to consider these other factors that might play a role in disease risk. Stroke is a disease of the elderly predominantly, and so learning more about things that can influence risk for stroke as people age is important."
Researchers measured chronic stress, anger and depression by taking into account influencing factors like personal health problems, health status of people close to them, job or ability to work, relationships and finances. They tracked hostility and a negative view of the world by assessing a person's expectations and motives of others.
"One thing we didn't assess is coping strategies," Everson-Rose said. "If someone is experiencing depressive symptoms or feeling a lot of stress or hostility, we don't know how they manage those, so it's possible that positive coping strategies could ameliorate some of these associations or effects," she said.
Other factors like age, race, sex, health behavior and other known stress factors were accounted for in the study.
The study appeared in the American Heart Association journal Stroke.
