DSpace Repository

Association of Psychosocial Stress with Risk of Acute Stroke

Show simple item record

dc.contributor.author Reddin, Catriona
dc.contributor.author Murphy, Robert
dc.contributor.author Hankey, Graeme J.
dc.contributor.author Judge, Conor
dc.contributor.author Xavier, Denis
dc.contributor.author Rosengren, Annika
dc.contributor.author Ferguson, John
dc.contributor.author Alvarez-Iglesias, Alberto
dc.contributor.author Oveisgharan, Shahram
dc.contributor.author Iversen, Helle K.
dc.contributor.author Lanas, Fernando
dc.contributor.author Al-Hussein, Fawaz
dc.contributor.author Czlonkowska, Anna
dc.contributor.author Oguz, Aytekin
dc.contributor.author McDermott, Clodagh
dc.contributor.author Pogosova, Nana
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.contributor.author Langhorne, Peter
dc.contributor.author Wang, Xingyu
dc.contributor.author Wasay, Mohammad
dc.contributor.author Yusuf, Salim
dc.contributor.author O'Donnell, Martin
dc.contributor.author INTERSTROKE investigators
dc.date.accessioned 2023-01-06T13:40:12Z
dc.date.available 2023-01-06T13:40:12Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/12996
dc.description.abstract 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 13462 patients with stroke and 13488 matched controls were recruited between January 11, 2007, and August 8, 2015. The present analyses were performed from June 1 to 30, 2021, and included 13350 cases and 13462 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 26812 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 stress were 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 at work (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. en_US
dc.language.iso eng
dc.publisher American Medical Association
dc.relation.ispartofseries JAMA Network Open
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Psychosocial Stress en_US
dc.subject Risk en_US
dc.subject Acute Stroke en_US
dc.title Association of Psychosocial Stress with Risk of Acute Stroke en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1001/jamanetworkopen.2022.44836
dc.relation.issn 2574-3805


Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

info:eu-repo/semantics/restrictedAccess Except where otherwise noted, this item's license is described as info:eu-repo/semantics/restrictedAccess

Search DSpace


Browse

My Account

Statistics