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Self-perceived psychological stress and ischemic stroke: a case-control study.

Artikel i vetenskaplig tidskrift
Författare Katarina Jood
Petra Redfors
Annika Rosengren
Christian Blomstrand
Christina Jern
Publicerad i BMC medicine
Volym 7
Sidor 53
ISSN 1741-7015
Publiceringsår 2009
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering
Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin
Sidor 53
Språk en
Länkar dx.doi.org/10.1186/1741-7015-7-53
Ämnesord Adolescent, Adult, Aged, Case-Control Studies, Female, Humans, Male, Middle Aged, Questionnaires, Stress, Psychological, complications, Stroke, epidemiology, etiology, Young Adult
Ämneskategorier Medicin och Hälsovetenskap

Sammanfattning

BACKGROUND: A growing body of evidence suggests that psychological stress contributes to coronary artery disease. However, associations between stress and stroke are less clear. In this study, we investigated the possible association between ischemic stroke and self-perceived psychological stress, as measured by a single-item questionnaire, previously reported to be associated with myocardial infarction. METHODS: In the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS), 600 consecutive patients with acute ischemic stroke (aged 18 to 69 years) and 600 age-matched and sex-matched population controls were recruited. Ischemic stroke subtype was determined according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Self-perceived psychological stress preceding stroke was assessed retrospectively using a single-item questionnaire. RESULTS: Permanent self-perceived psychological stress during the last year or longer was independently associated with overall ischemic stroke (multivariate adjusted odds ratio (OR) 3.49, 95% confidence interval (CI) 2.06 to 5.93). Analyses by stroke subtype showed that this association was present for large vessel disease (OR 3.91, 95% CI 1.58 to 9.67), small vessel disease (OR 3.20, 95% CI 1.64 to 6.24), and cryptogenic stroke (OR 4.03, 95% CI 2.34 to 6.95), but not for cardioembolic stroke (OR 1.48, 95% CI 0.64 to 3.39). CONCLUSION: In this case-control study, we found an independent association between self-perceived psychological stress and ischemic stroke. A novel finding was that this association differed by ischemic stroke subtype. Our results emphasize the need for further prospective studies addressing the potential role for psychological stress as a risk factor for ischemic stroke. In such studies ischemic stroke subtypes should be taken into consideration.

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