Is psycho-physical stress a risk factor for stroke? A case-control study

Egido, J.; Castillo, Olga; Roig, Beatriz; Sanz, Itziar Reguero; Herrero, Maria Rosa; Garay, M. T.; Garcia, Ana Luís; Fuentes, Manuel; Fernández, Cristina

doi:10.1136/jnnp-2012-302420

Cited by 34 publications

(26 citation statements)

References 33 publications

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“…Health-related QoL has been reported to independently predict mortality following Coronary Artery Bypass Grafting (CABG) 3 , Myocardial Infarction (MI) 4,5 , heart failure 6 , Diabetes Mellitus 78 , and Hemodialysis 9 . Egido et al found that psychosocial stress predicted stroke in a small case-control study, implying that QoL is a significant causative role 1011 . Socioeconomic factors influencing QoL such as unemployment or multiple job losses, may be significant risk factors for acute MI and stroke 121314 .…”

Section: Introductionmentioning

confidence: 99%

Baseline Quality of Life and Risk of Stroke in the ALLHAT Study (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)

Shams

Auchus

Oparil

et al. 2017

Stroke

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Background and Purpose The visual analogue scale (VAS) is a self-reported, validated tool to measure quality of life (QoL). Our purpose was to determine whether baseline QoL predicted strokes in the ALLHAT study and evaluate determinants of post-stroke change in QoL. In the ALLHAT study, among the 33,357 patients randomized to treatment arms, 1,525 suffered strokes; 1,202 (79%) strokes were non-fatal. This study cohort includes 32,318 (97%) subjects who completed the baseline VAS QoL estimate. Methods QoL was measured on a VAS and adjusted using a Torrance transformation (TQoL). Kaplan-Meier curves and adjusted proportional hazards analyses were used to estimate the effect of TQoL on the risk of stroke, on a continuous scale (0–1) and by quartiles (≤0.81, >0.81 ≤0.89, >0.89≤0.95, >0.95). We analyzed the change from baseline to first post-stroke TQoL using adjusted linear regression. Results After adjusting for multiple stroke risk factors, the hazard ratio for stroke events for baseline TQoL was 0.93 (95% CI 0.89–0.98) per 0.1 unit increase. The lowest baseline TQoL quartile had a 20% increased stroke risk (HR =1.20 [CI 1.00–1.44]) compared to the reference highest quartile TQoL. Post-stroke TQoL change was significant within all treatment groups (p≤.001). Multivariate regression analysis revealed that baseline TQoL was the strongest predictor of post-stroke TQoL with similar results for the untransformed QoL. Conclusions The lowest baseline TQoL quartile had a 20% higher stroke risk than the highest quartile. Baseline TQoL was the only factor that predicted post-stroke change in TQoL. Clinical Trials Registration https://clinicaltrials.gov/ct2/show/NCT00000542?term=allhat&rank=3 Unique Identifier: NCT00000542

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Section: Introductionmentioning

confidence: 99%

Baseline Quality of Life and Risk of Stroke in the ALLHAT Study (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)

Shams

Auchus

Oparil

et al. 2017

Stroke

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“…Therefore, some sort of biological rationale suggests perhaps in acute stressful situations a person could be at risk of stroke. According to studies by Egido et al (2012), compared with healthy age-matched individuals, stressful habits and type A behavior are associated with high risk of stroke. This association is not modified by gender.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Findings of Tashkent Hospital Based Study of Risk Factors for Different Ischemic Stroke Subtypes

Rasulova

2014

EMHPJ

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Objective: To determine risk factors in different pathogenic subtypes of ischemic stroke in Tashkent hospital registry and to compare with the data of other stroke registers.Design: Prospective observational study.Participants: 300 adults aged 18 years or over who suffered first-ever acute ischemic stroke, of them, the data of 100 patients with atherothrombotic, lacunar and cardioembolic strokes were analyzed.Main outcome measures: Mathematically significant differences and not significant differences but interesting from other point of view. Categorical variables are expressed as frequencies and percentages. Differences were regarded as statistically significant when the P value was less than 0.05 (P<0.05).Results: Of 100 patients with acute first-ever ischemic stroke at the median age of 62.63±4.68 (interquartile range 25-92) years, 57% were men and 43% were women. Depending on aetiology and stroke subtype, all the patients were divided into three groups: 42 patients with atherothrombotic stroke, 41 -with lacunar stroke, and 17 patients with cardioembolic stroke. Atherothrombotic stroke developed often in people over 60 years old, while lacunar stroke prevailed at the younger age. Stroke cases increased in people over 51 years old. Although men were more likely to suffer strokes than women, stroke incidence was equal in both sexes with increasing of age (over 60 years old), especially in atherothrombotic stroke, testifying to that women live longer. Combination of cerebral atherosclerosis and hypertension was the most significant risk factor for stroke. Atherosclerosis was the main aetiological factor for ischemic stroke, independently of its pathogenic heterogeneity. Diabetes mellitus was an independent risk factor for all stroke subtypes, which in most cases worsened the course and outcome of stroke. Hypertension was the leader aetiological factor for lacunar stroke. In these patients, weCardioembolic stroke developed mainly because of cardiac thrombosis and valve pathology, which were often associated with chronic diseases of other organs, worsening the course and outcome of stroke. Despite of high prevalence of myocardial infarction in men, women were more likely to develop cardioembolic stroke.Conclusions: This study found simultaneous influence of many risk factors (multifactorial disease) in the development of ischemic stroke. The more course and influence of the underlying disease and risk factor, the higher stroke risk and severity, especially in the absence or inadequate previous therapy of underlying disease before the stroke index. We have noted a high prevalence of under-diagnosis of vascular risk factors at levels of primary and secondary care. We recommend for improved public awareness of vascular risk factors and better diagnostic and treatment facilities aimed at addressing those factors at levels of primary and secondary healthcare. Larger population-based studies may provide additional data on stroke incidence and outcome among Uzbeks.

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“…The recent stress in patient's life could be a significant risk factor for stroke in young population. A case control study by Egido et al 8 disclosed that stressful habits are significantly associated with high risk of stroke. Other case reports conclude that oral contraceptives may be implicated as a cause of basilar artery thrombosis 7 9.…”

Section: Discussionmentioning

confidence: 99%

A conversion disorder or a stroke? A proximal basilar artery thrombosis induced ‘locked-in’ syndrome in a young Caucasian woman

Brandon

Smith

et al. 2013

BMJ Case Reports

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SUMMARYThe incidence of the basilar artery occlusion is relatively low among all strokes. Clinical presentation varies depending on the location of the occlusion. The symptoms include mild dysarthria to coma or sudden death. The initial subtle clinical presentation could lead to misdiagnosis. Psychogenic diagnosis in the differential could make the timely diagnosis more difficult. This case involves a 34-year-old woman presenting with a gradual onset of slurred speech. The initial CT scan of head did not indicate any intracranial pathology, and she was initially treated for an anxiety/conversion disorder. With progression of the pathology, the patient quickly developed a 'locked-in' syndrome, with preserved high cognitive function and vertical eye movement, but otherwise total loss of motor function. The diagnosis was confirmed with MRI/MR angiography studies, which indicated thrombosis of the proximal basilar artery. Serological studies did not disclose any relevant risk factors. BACKGROUND

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Is psycho-physical stress a risk factor for stroke? A case-control study

Abstract: Compared with healthy age-matched individuals, stressful habits and type A behaviour are associated with high risk of stroke. This association is not modified by gender.

Cited by 34 publications

References 33 publications

Baseline Quality of Life and Risk of Stroke in the ALLHAT Study (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)

Baseline Quality of Life and Risk of Stroke in the ALLHAT Study (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)

Preliminary Findings of Tashkent Hospital Based Study of Risk Factors for Different Ischemic Stroke Subtypes

A conversion disorder or a stroke? A proximal basilar artery thrombosis induced ‘locked-in’ syndrome in a young Caucasian woman

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