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Stroke Tied To Overreaction To Stress

For the first time, stress has been linked to an increased risk of stroke, especially ischemic stroke, in middle-aged white men.

Furthermore, low socioeconomic status confers added risk, suggests an international study.

Men in this study with exaggerated systolic reactivity had 72 percent greater risk of any stroke and 87 percent greater risk of ischemic stroke relative to less reactive men.

Although exaggerated blood pressure reactivity to stress is linked with atherosclerosis and hypertension, which are known risk factors for stroke, the relation of stress to stroke has been unknown. Some studies have also suggested that the link between reactivity and cardiovascular disease may be influenced by socioeconomic status.

Participants in this joint work by researchers in the United States and Finland were 2,303 men in their early 50s from a population-based, longitudinal study of risk factors for ischemic heart disease in eastern Finland.

Among these men, researchers in this study examined the impact of blood pressure reactivity and socioeconomic status on incident stroke.

Reactivity was calculated as the difference between blood pressure measured before exercise and resting blood pressure measured one week earlier.

Mean systolic reactivity was 20 mm Hg and mean diastolic reactivity was 8.6 mm Hg. Socioeconomic status was assessed as years of education.

In 11.2 years of follow-up, 113 incident strokes (90 of them ischemic) occurred.

Not only were men with high level of blood pressure reactivity at significantly higher risk of stroke, but also those who were both high reactors and poorly educated were nearly three times more likely to have a stroke than better educated, less reactive men.

Taking into account stroke risk factors had little impact on these associations.

Diastolic reactivity was found to be unrelated to stroke risk.

Thus, excessive sympathetic reactivity to stress may be etiologically important in stroke, and low socioeconomic status adds to the risk, these researchers conclude.

Susan A. Everson and colleagues from the University of Michigan, Ann Arbor, Michigan, United States, and the University of Kuopio and Brain Research and Rehabilitation Center, Neuron, Kuopio, Finland, did this research.
Stroke. 2001;32:1263.

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