Stress is rarely a good thing for your health, but new research warns that it significantly raises the risk of a stroke.
The study found that increased stress at home or work and recent stressful life events — like getting divorced or a major family conflict — were associated both with increased risk of stroke due to a clot, known as an ischemic stroke, and a stroke due to bleeding in the brain, called a hemorrhagic stroke.
What to do to lower that risk?
“Optimal approaches to managing, and preventing, psychosocial stress are uncertain. Previous studies have looked at interventions such as cognitive behavioral therapy, relaxation techniques, client-led discussion, stress management, exercise regimens and anger management,” said study author Dr. Catriona Reddin, of the University of Galway College of Medicine, Nursing and Health Sciences, in Ireland.
“The most effective approach may vary from person to person. It's important that everyone has a strategy that works for them,” Reddin said.
Her team studied stress around the world using data from a retrospective study known as INTERSTROKE in more than 26,000 people in 32 countries in North and South America, Africa, Asia, Europe, Australia and the Middle East.
People who had severe work stress were more than twice as likely to have an ischemic stroke as those with no work stress, the investigators found. They were more than five times as likely to have a hemorrhagic stroke.
For those living with either home or work stress, people who felt they could control what happens in their life had a lower stroke risk than those who felt they did not have control.
The findings about perceived control over a situation are important, Reddin said.
These “might be important targets for mitigating the adverse cardiovascular effects of psychosocial stress. In particular, workplace interventions may be promising,” Reddin said.
More than 795,000 people in the United States suffer a stroke each year, with one happening about every 40 seconds, according to the U.S. Centers for Disease Control and Prevention. About 87% of those are ischemic strokes. U.S. costs were about $53 billion between 2017 and 2018 for health care, medicines and missed work due to stroke.
In addition to stress, other risk factors for stroke include high blood pressure, physical inactivity, poor diet, smoking, diabetes and cardiac issues such as atrial fibrillation.
“Our message is for people to practice mental and physical wellness at all ages,” Reddin said. “Some of the ways to reduce your risk of stroke are to maintain a healthy lifestyle, exercise regularly, treat high blood pressure and not to smoke.”
The findings were published online recently in JAMA Network Open.
People are under a lot of stress right now, said Dr. Howard Liu, chair of the department of psychiatry at the University of Nebraska Medical Center and chair of the council on communications for the American Psychiatric Association.
Causes of stress include disrupted childcare, uncertainty in the job market, struggles with inflation and disconnected relationships.
“I think what this study mainly reminds us of is that these things matter,” said Liu, who was not involved in the research.
Liu offered some suggestions for how someone can reduce stress in their own life.
Though people might think of exercise as being exclusively beneficial for physical health, it's also known for helping mild to moderate depression and anxiety.
“I think one of the things that I've learned just in my own life is to truly try to schedule things in. I have some colleagues that really are very good about scheduling workouts during lunch breaks, and will actually do it at work, go for a walk and these kind of things,” Liu said. “I think the more integration you have into your routine, and then the more you can actually block out that time, the better.”
Loneliness is another issue, Liu said.
“I think finding time for intentional connection is really important,” Liu said. “It's just the principle of really trying to prioritize some of those close relationships and building that in as not just an occasional thing, but a regular part of your day. I think that's important.”
Liu also suggests a tool he learned from a mentor in which someone would once a year draw a pie chart on how they're spending their time and another one on their ideal.
“If your whole pie is about work or if your whole pie is about being a caretaker for somebody that's ill, or whatever it is, and none of it's on self-care, what are some of the systemic changes that you can make to your week,” Liu said.
Look at limiting screen time because of what it displaces, he suggested.
In addition to exercise, connection and deciding how you want to spend your time, mindfulness is another good strategy.
“People achieve that in different ways," Liu said. "And just taking time to take a breather and really clear your mind, some people achieve that spiritually through prayer and other means as well, but finding time to just calm yourself, do some breathing exercises, those kind of things can be helpful as well."
The U.S. Centers for Disease Control and Prevention has more on stroke.
SOURCES: Catriona Reddin, MB, University of Galway College of Medicine, Nursing and Health Sciences, Ireland; Howard Liu, MD, MBA, adult and child psychiatrist and chair, council on communications, American Psychiatric Association, and chair, department of psychiatry, University of Nebraska Medical Center, Omaha, Neb.; JAMA Network Open, Dec. 9, 2022, online