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Poor Stress-Responses May Open Way For Stroke

Hypertensive men who chronically fail to find successful ways to deal with stress may be vulnerable to its damaging effects and thus are at increased risk of stroke.

This is one interpretation of findings in a Swedish study of adaptive behaviour in stressful situations and stroke incidence in hypertensive men.

Although hypertension is a major risk factor for stroke, many hypertensives remain healthy.

To analyse whether adaptation to a stressful situation is linked with incidence of stroke in male hypertensives was the objective of this study.

Lena André-Petersson and colleagues from Malmö University Hospital and Lund University, Malmö; the Gerontology Research Center, Lund; and Göteborg University, Göteborg did this work.

Study participants were 238 men who were followed from baseline in 1982-83 until first stroke, death or December 31, 1996 in the Prospective Cohort Study "Men Born In 1914" in Malmo.

To examine adaptation to stress, researchers used the serial Color-Word Test; four patterns of adaptation could be distinguished according to the level of mastery of the test.

These were stabilized patterns, increasing difficulty in cumulative patterns, fluctuating difficulty in dissociative patterns and fluctuating difficulty that increased during testing in cumulative-dissociative patterns.

Patterns were compared in relation to stroke incidence.

Of the 238 men, 43 experienced a stroke during follow-up. Stroke rates per 1,000 person-years were 12.6 for men with stabilized patterns, 14.3 for men with cumulative, 16.2 for those with dissociative, and 31.2 for those with cumulative-dissociative patterns.

When researchers took relevant cerebrovascular risk factors into account, the cumulative-dissociative pattern was linked with increased risk of stroke in the follow-up period.

Study authors suggest the finding may indicate that, among hypertensive men, chronic poor responders to stress versus those who adapt easily to it may be at higher stroke risk.
Stroke. 2001;32:1712.

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