Universidad Peruana Cayetano Heredia
Association of Psychosocial Stress with Risk of Acute Stroke
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| 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 |
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