Factors such as race, age, gender, level of education attained, stroke risk, history of chronic health conditions and medications to control blood pressure or relieve depression were identified so they would not affect the conclusions drawn from the data. Notably, race and sex did not affect stroke risk, the study authors said.
Researchers identified 151 deaths from stroke and 452 events that led to being hospitalized for a stroke. The deaths were verified by the National Death Index and the hospitalizations were based on Medicare claims from the U.S. Center for Medicare and Medicaid Services.
The study showed that increasing levels of distress are related to increased risk of both fatal and nonfatal stroke in black and white seniors. The researchers also found that stress was associated with increased risk of hemorrhagic stroke, the type caused by a brain artery bleeding, but not by ischemic stroke, which is caused by a blood clot in an artery.
Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine, explained how stress could be related to a stroke specifically caused by bleeding. "Increased blood pressure and abnormalities in blood clotting have previously been shown to be associated with stroke," he said.
Sacco noted that it was especially interesting that the researchers identified what is called a dose response: the most distressed participants experienced more than a twofold increased risk of stroke mortality and a 32 percent increased risk of stroke, compared with those who reported less stress.
"The study adds to the growing evidence that stress is a significant factor in cardiovascular disease and stroke," Sacco said.
The study found a link between greater levels of distress and stroke incidence in seniors. It did not prove cause-and-effect.
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