Repositorio UFRO · Omeka S

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	http://dx.doi.org/10.1001/jamanetworkopen.2022.44836
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