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Negative Emotions Can Increase Stroke Risk

A new study has found a connection between emotional stress and stroke mortality.

--by Suzanne Boothby A depressed older woman

The Gist

New research may motivate you to maintain a positive outlook as you age. People 65 and older with high psychosocial distress, characterized by depression, stress, a negative outlook, and dissatisfaction with life, face an increased risk of stroke, according to new research published this week in the American Heart Association journal Stroke.

Depression by itself has already been linked to many health problems, including stroke, according to the National Institute of Mental Health.

In this new, 10-year study, patients with the most psychosocial distress had three times the risk of death from stroke and a 54 percent increased risk of first hospitalization due to stroke compared to those who were least distressed. The impact of emotional distress on stroke risk did not differ by race or by sex, the researchers said.

The Expert Take

"People should be aware that stress and negative emotions often increase with age," said Susan Everson-Rose, Ph.D., M.P.H., senior study author and associate director of the Program in Health Disparities Research at the University of Minnesota. "Family members and caregivers need to recognize that these emotions have a profound effect on health."

Dr. Larry Goldstein, director of the Duke Stroke Center, said it’s important to remember that this study shows an association, but does not prove causality.

“The research did adjust for a fair number of elements, but some things, like alcohol use, diet, and use of medications, were not looked at in this study,” Goldstein said. “But this is not the only epidemiological study to show a link between depression and stroke. Other studies have suggested this relationship, and it’s important to consider even if it is only an association.”

One of the best ways to help prevent stroke is for doctors to discuss all possible risk factors with their patients.

“Talking to patients about life stressors is always an important part of any medical evaluation,” Goldstein said.

Source and Method

Researchers tracked 4,120 people who participated in the Chicago Health and Aging Project for rates of death and stroke incidents. Because some participants were in an HMO, only 2,649 participants were analyzed for rates of stroke incidence.

Participants were 65 and older, with an average age of 77. About 62 percent were women and about 61 percent were African American. Researchers identified 151 deaths from stroke and 452 events that led to first-time hospitalizations for stroke.

The researchers measured psychosocial distress using four indicators: perceived stress, life dissatisfaction, neuroticism, and depressive symptoms. They used standardized rating scales to determine the score on each indicator for each participant.

Scientists also conducted in-depth interviews in homes in three neighborhoods on the south side of Chicago representing African-Americans and Caucasians from the same socio-economic spectrum. The interviews covered medical history, cognitive function, socioeconomic status, behavioral patterns, traditional risk factors for stroke, and psychosocial characteristics.

The Takeaway

Stress and lifestyle factors are important to consider as you age, especially if you have other risk factors for stroke. The National Stroke Association estimates that about 80 percent of strokes can be prevented.

"It's important to pay attention when older people complain of distress and recognize that these symptoms have physical effects on health outcome and clearly affect stroke risk," Everson-Rose said.

Other Research

A 2011 study published in the Journal of the American Medical Association found that people with depression are more likely to have a stroke and that their strokes are more likely to be fatal.

"If you have depression but no other health issues, you probably don't have to pay too much attention to stroke risk," said Dr. An Pan, Ph.D., lead author of the analysis and a research fellow at the Harvard School of Public Health, in a CNN article. "But if you are depressed and are also obese, or have hypertension or...unhealthy lifestyle factors, your risk is going to increase dramatically."

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Tags: Awareness , Latest Studies & Research

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