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The Connection Between Stress and Stroke Risk

Stress and Stroke Risk: Here's How They're Linked

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Updated August 14, 2009

What’s the connection between stress and stroke risk? According to the American Medical Association, roughly 80% or doctor visits are stress-related, but what about major, deadly conditions like stroke?

Conventional wisdom has said that stress leads to stroke. Medical research has found some connections, but has had a more difficult time proving that one clearly causes the other. However, a growing body of research seems to show a link. Here’s a sample of what researchers have found:

  • A University of Michigan study found that men who were more physiologically reactive to stress (as measured by high blood pressure) were 72% more likely to suffer a stroke.

  • A recent study of 6553 Japanese male and female workers examined job stress levels and found that men (though not women) in jobs that involved high demands and lower levels of personal control (in other words, more stressful jobs) were at greater stroke risk, even after controlling for variables like age, educational attainment, occupation, smoking status, alcohol consumption, physical activity, and study area.

  • One study measured levels of adaptation to stress—how well participants managed stress, and the associated risk. They found that those who had difficulty managing stress appeared to be at an increased risk of stroke. “One interpretation,” they write of their results, “is that hypertensive men who chronically fail to find successful strategies in stressful situations are vulnerable to the damaging effects of stress and thereby at an increased risk of a future stroke.”
  • What we know can be summed up with this, from researchers from The Copenhagen City Heart Study, who asked people about their stress levels and analyzed their health outcomes: “Self-reported high stress intensity and weekly stress were associated with a higher risk of fatal stroke compared with no stress. However, there were no significant trends, and the present data do not provide strong evidence that self-reported stress is an independent risk factor for stroke.”

However, while stress is linked, but not firmly established as an independent risk factor for stroke, it’s important to note that stress is linked with several firmly-established risk factors for stroke, such as high blood pressure, smoking and obesity. (Read more about stress and weight gain, blood pressure, and smoking.)

In addition to potentially raising stroke risk, stress is associated with poorer outcomes for those who have already had a stroke, as well as their families.

While more research needs to be done, there is enough evidence of a stress-and-stroke-risk relationship that I feel very comfortable recommend stress management strategies as one means of lowering risk.

Here are some stress management tips and resources for those concerned about lowering their stroke risk, as well as those who have already suffered a stroke, or care for stroke survivors.

Quick Stress Relievers

Reversing your stress response quickly is a simple and effective first line of defense against stress. It can help prevent the negative effects of chronic stress, especially if used as part of an overall stress management plan.

Healthy Lifestyle Changes

Adopting a healthy lifestyle can reduce stress as well as risk for major diseases and conditions. Learn more about changes that make the biggest difference.

Social Support

Having a supportive social circle has been linked with better post-stroke outcomes for both stroke survivors and their caregivers. Learn more about social support and maintaining a strong supportive circle. Sources

Akizumi Tsutsumi, MD; Kazunori Kayaba, MD; Kazuomi Kario, MD; Shizukiyo Ishikawa, MD. Prospective Study on Occupational Stress and Risk of Stroke. Archives of Internal Medicine, 2009.

André-Petersson, Lena, MS; Engström, Gunnar, MD, PhD; Hagberg, Bo, PhD; Janzon, Lars, MD, PhD; Steen, Gunilla, MS Adaptive Behavior in Stressful Situations and Stroke Incidence in Hypertensive Men. © 2001 American Heart Association, Inc.

Boden-Albala B, Sacco RL. Lifestyle factors and stroke risk: exercise, alcohol, diet, obesity, smoking, drug use, and stress. Current Artherosclerosis Reports. March, 2000.

Everson, Susan A. PhD, MPH; John W. Lynch, PhD, MPH; George A. Kaplan, PhD; Timo A. Lakka, MD, PhD; Juhani Sivenius, MD, PhD Jukka T. Salonen, MD, PhD, MScPH. Stress-Induced Blood Pressure Reactivity and Incident Stroke in Middle-Aged Men. Psychosomatic Medicine, 1999.

Truelsen, Thomas, MD, PhD; Nielsen, Naja, BMsc; Gudrun Boysen, MD, DMSc, Grønbæk, Morton, MD, DMSc. Self-Reported Stress and Risk of Stroke. Stroke, 2003.

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