Abstract
Background
Conventional risk factors for stroke that have been identified are mostly chronic
diseases that explain much of the variation as to who develops stroke. However, these
risk factors do not equip us with the means to predict when an event like stroke will
occur. It has been observed that acute events like stroke and coronary heart disease
are preceded by episodes of acute stress. The present study was undertaken to determine
whether acute psychological stress is a potential triggering factor for the occurrence
of stroke.
Methods
In accordance with the case-crossover study design, patients or Legally Authorized
Representative (LAR) were asked to report psychological stress during the two-hour
hazard period before the event and during the control period, which was the same 2-hour
time period the day before the event. Conditional logistic regression was used to
compare each person's exposure during the hazard period to their exposure during the
control period.
Results
A total of 151 stroke patients were interviewed. Acute psychological stress was associated
with transient increased odds of stroke in the subsequent 2 hours that was 3.4 times
higher than the odds during periods with no exposure to these triggers (95% confidence
interval 1.55-7.50).
Conclusions
Acute psychological stress is a potential independent triggering factor for the occurrence
of stroke. Further confirmatory studies are required to help corroborate these findings
and elucidate the mechanisms underlying this short-term increase in risk.
Key Words
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Article info
Publication history
Published online: April 02, 2020
Accepted:
February 29,
2020
Received in revised form:
February 21,
2020
Received:
January 30,
2020
Footnotes
Financial disclosure: This study did not receive any funding.
Co-authors: Dr. Pardeep Khanna, MD, Professor and HOD, Department of Community Medicine, PGIMS, Rohtak-124001. Ph: +91-986839093. Dr. V. K. Katyal, MD, Professor, Department of Medicine, PGIMS, Rohtak-124001. Ph: +91-9991258540. Dr. Ramesh Verma, MD, Professor, Department of Community Medicine, PGIME, Rohtak-124001. Ph: +91-9416381012.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104799
Copyright
© 2020 Elsevier Inc. All rights reserved.
