Self-perceived psychological stress and ischemic stroke: a case-control study
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BioMed Central
Open Access
Research article
Self-perceived psychological stress and ischemic stroke: a case-control study Katarina Jood*1, Petra Redfors1, Annika Rosengren2, Christian Blomstrand1 and Christina Jern1,3 Address: 1Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Göteborg, Göteborg, Sweden, 2Department of Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden and 3Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden Email: Katarina Jood* - [email protected]; Petra Redfors - [email protected]; Annika Rosengren - [email protected]; Christian Blomstrand - [email protected]; Christina Jern - [email protected] * Corresponding author
Published: 1 October 2009 BMC Medicine 2009, 7:53
doi:10.1186/1741-7015-7-53
Received: 22 August 2009 Accepted: 1 October 2009
This article is available from: http://www.biomedcentral.com/1741-7015/7/53 © 2009 Jood et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract 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 selfperceived 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
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