Medisch

Psychologische stress verhoogd kans op CVA

Uit onderzoek blijkt dat psychologische stress de kans op een herseninfarct (CVA) significant verhoogd. Dit blijkt uit onderzoek wat 4 maart in Neurology gepubliceerd is. De psychologische druk vergroot de kans met 11% over 8 jaar. Er is geen relatie gevonden tussen depressie en het herseninfarct.
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P. G. Surtees, N.W.J. Wainwright, R. N. Luben, N. J. Wareham, S. A. Bingham, and K.-T Khaw

Psychological distress, major depressive disorder, and risk of stroke 

Neurology 2008 70: 788-794. [Abstract] [Full Text] [Figures Only] [PDF]  
 Het volledige bericht van ACEP/Elsevier:

Psychological distress is associated with significantly greater risk of stroke, but depressive episodes are not, according to a large British population study published March 4 in Neurology.The study of more than 20,000 residents of Norfolk taking part in the United Kingdom arm of the 10-country European Prospective Investigation Into Cancer found that lower baseline scores on a mental health inventory (indicating greater distress) were associated with an 11% increased risk of stroke over 8 years of follow-up after adjustment for known stroke risk factors. The association indicated a dose-response relationship.Having a major depressive episode in the 12 months before the baseline mental-health assessment or at any point in their lives was not significantly associated with a greater stroke risk, however (Neurology 2008;70:788-94).The study investigators said their research clarifies the relationship between mental health and stroke. Previous studies have focused on the relationship between a diagnosis of depression and stroke; in the current study, use of the five-item version of the Mental Health Inventory (MHI-5) assessed mental health well-being and allowed the researchers to focus on its relationship to stroke.“Understanding the mechanisms by which overall emotional health may increase stroke risk may inform stroke prevention and help identify those at increased stroke risk,” the study’s lead author, Paul Surtees, Ph.D., of the University of Cambridge, England, said in a written statement.Of the 20,627 study participants aged 41-80, none of whom had a history of stroke at baseline, 5% reported having an episode of major depressive disorder (MDD) in the previous 12 months and 15% reported having such an episode any time during their lives.Mean score on the MHI-5 was 55.2 for those who had experienced an MDD episode in the past 12 months, 76.5 for those who had an MDD episode at any time, and 78.5 for participants who reported never having an MDD episode.The researchers identified 595 strokes in 8.5 years of follow-up, 167 of which were fatal.For every standard deviation lower score on the MHI-5, overall stroke risk increased by 11% (hazard ratio 1.11), after adjustment for such cardiovascular risk factors as smoking, obesity, diabetes, and family history of stroke. A single standard deviation lower score on MHI-5 resulted in an adjusted hazard ratio of 1.22 for fatal stroke.There was not a significantly elevated risk of stroke among study participants who had experienced an MDD episode in last 12 months or at any point in their lives, however.The researchers acknowledged that their study may not have been fully representative of the UK population, because it required study participants to provide detailed dietary and biological information, resulting in a population that included fewer smokers than the general population.In addition, the age range may have limited how well the findings can be generalized to the population at large, while use of death certificates and hospital admissions to identify study participants may have led to some less severe strokes not being identified, the researchers said. 

 

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