Association of Psychosocial Stress With Risk of Acute Stroke

Primer Autor
Reddin, Catriona
Co-autores
Murphy, Robert
Hankey, Graeme J.
Judge, Conor
Xavier, Denis
Rosengren, Annika
Ferguson, John
Alvarez-Iglesias, Alberto
Oveisgharan, Shahram
Iversen, Helle K.
Lanas, Fernando
Al-Hussein, Fawaz
Czlonkowska, Anna
Oguz, Aytekin
McDermott, Clodagh
Pogosova, Nana
Malaga, German
Langhorne, Peter
Wang, Xingyu
Wasay, Mohammad
Yusuf, Salim
O'Donnell, Martin
Título
Association of Psychosocial Stress With Risk of Acute Stroke
Editorial
AMER MEDICAL ASSOC
Revista
JAMA NETWORK OPEN
Lenguaje
en
Resumen
IMPORTANCE Psychosocial stress is considered a modifiable risk factor for stroke. Given the prevalence of chronic and acute exposure to stress, it represents a potentially attractive target for population-health interventions. OBJECTIVES To determine the association of psychosocial stress with the risk of acute stroke and explore factors that might modify the association of stress with risk of acute stroke in a large international population. DESIGN, SETTING, AND PARTICIPANTS INTERSTROKE is an international retrospective case-control study of risk factors for first acute stroke in 32 countries in Asia, North and South America, Europe, Australia, the Middle East, and Africa. A total of 13 462 patients with stroke and 13 488 matched controls were recruited between January 11, 2007, and August 8, 2015. The present analyseswere performed from June 1 to 30, 2021, and included 13 350 cases and 13 462 controls with available data on psychosocial stress. EXPOSURES Psychosocial stress and occurrence of stressful life events within the preceding year were measured using a standardized questionnaire of self-reported stress at home and work. MAIN OUTCOMES AND MEASURES The association of stress with acute stroke and its subtypes was examined using multivariable conditional logistic regression and factors that might modify the association, particularly self-reported locus of control. RESULTS Among 26 812 participants included in the analysis, the mean (SD) age of cases was 62.2 (13.6) years, that of controls, 61.3 (13.3) years, 7960 cases (59.6%) and 8017 controls (59.6%) were men. Several periods of stress and permanent stresswere reported for 2745 cases (20.5%) and 1933 controls (14.4%), with marked regional variation in prevalence, with the lowest in China (201 of 3981 [5.0%] among controls and 364 of 3980 [9.1%] among cases) and highest in South East Asia (233 of 855 [26.1%] among controls and 241 of 782 [30.8%] among cases). Increased stress at home (odds ratio [OR], 1.95 [95% CI, 1.77-2.15]) and atwork (OR, 2.70 [95% CI, 2.25-3.23]) and recent stressful life events (OR, 1.31 [95% CI, 1.19-1.43]) were associated with an increased risk of acute stroke on multivariable analyses (vs no self-reported stress). Higher locus of control at home was associated with a reduced odds of all stroke (OR, 0.73 [95% CI, 0.68-0.79]), and higher locus of control both at work and at home were associated with a lower odds of acute stroke and significantly diminished the association with stress at work (OR, 2.20 [95% CI, 1.88-2.58], P =.008 for interaction) and home (OR, 1.69 [95% CI, 1.44-1.98], P <.001 for interaction) for acute stroke. CONCLUSIONS AND RELEVANCE Psychosocial stress is a common risk factor for acute stroke. The findings of this case-control study suggest that higher locus of control is associated with lower risk of stroke and may be an important effect modifier of the risk associated with psychosocial stress.
Fecha Publicación
2022
Tipo de Recurso
artículo original
doi
10.1001/jamanetworkopen.2022.44836
Formato Recurso
PDF
Palabras Claves
Case-Control Studies
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Stress, Psychological / complications
Stress, Psychological / epidemiology
Stroke / epidemiology
Stroke / etiology
Ubicación del archivo
Categoría OCDE
Medicina general e interna
Materias
Estudios de casos y controles
Mujer
Humanos
Masculino
mediana edad
Estudios Retrospectivos
Factores de riesgo
Estrés Psicológico / complicaciones
Estrés Psicológico - epidemiología
Accidente cerebrovascular- epidemiología
Accidente cerebrovascular / etiología
Identificador del recurso (Mandatado-único)
artículo original
Versión del recurso (Recomendado-único)
versión publicada
License
CC BY 4.0
Condición de la licencia (Recomendado-repetible)
CC BY 4.0
Derechos de acceso
acceso abierto
Access Rights
acceso abierto
Id de Web of Science
WOS:000937072600005
ISSN
2574-3805
Tipo de ruta
verde# dorada
Categoría WOS
Medicina general e interna
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