Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-analysis

Joanne Booth*, Lesley Connelly, Maggie Lawrence, Campbell Chalmers, Sara Joice, Clarissa Becker, Nadine Dougall

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Background : Several studies suggest that perceived psychosocial stress is associated with increased risk of stroke; however results are inconsistent with regard to definitions and measurement of perceived stress, features ofindividual study design, study conduct and conclusions drawn and no meta-analysis has yet been published. We performed a systematic review and meta-analysis of studies assessing association between perceived psychosocialstress and risk of stroke in adults.The results of the meta-analysis are presented.
Methods: Systematic searches of MEDLINE, EMBASE, CINAHL, PsycInfo, and Cochrane Database of Systematic Reviews were undertaken between 1980 and June 2014. Data extraction and quality appraisal was performed by two independent reviewers. Hazard ratios (HR) and odds ratios (OR) were pooled where appropriate.
Results: 14 studies were included in the meta-analysis, 10 prospective cohort, 4 case–control design. Overall pooled adjusted effect estimate for risk of total stroke in subjects exposed to general or work stress or to stressful life events was 1.33 (95 % confidence interval [CI], 1.17, 1.50; P < 0.00001). Sub-group analyses showed perceived psychosocial stress to be associated with increased risk of fatal stroke (HR 1.45 95 % CI, 1.19,1.78; P = 0.0002), totalischaemic stroke (HR 1.40 95 % CI, 1.00,1.97; P = 0.05) and total haemorrhagic stroke (HR 1.73 95 % CI, 1.33,2.25; P > 0.0001).A sex difference was noted with higher stroke risk identified for women (HR 1.90 95 % CI, 1.4, 2.56:P < 0.0001) compared to men (HR 1.24 95 % CI, 1.12, 1.36; P < 0.0001).
Conclusions: Current evidence indicates that perceived psychosocial stress is independently associated with increased risk of stroke.
Original languageEnglish
Article number233
Number of pages12
JournalBMC Neurology
Volume15
DOIs
Publication statusPublished - 12 Nov 2015

Keywords

  • stress
  • psychological
  • stroke
  • risk factor

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