Journal article
Chronic Stress, Depressive Symptoms, Anger, Hostility, and Risk of Stroke and Transient Ischemic Attack in the Multi-Ethnic Study of Atherosclerosis
Stroke (1970), v 45(8), pp 2318-2323
01 Aug 2014
PMID: 25013018
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background and Purpose-This study investigated chronic stress, depressive symptoms, anger, and hostility in relation to incident stroke and transient ischemic attacks in middle-aged and older adults.
Methods-Data were from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based cohort study of 6749 adults, aged 45 to 84 years and free of clinical cardiovascular disease at baseline, conducted at 6 US sites. Chronic stress, depressive symptoms, trait anger, and hostility were assessed with standard questionnaires. The primary outcome was clinically adjudicated incident stroke or transient ischemic attacks during a median follow-up of 8.5 years.
Results-One hundred ninety-five incident events (147 strokes; 48 transient ischemic attacks) occurred during follow-up. A gradient of increasing risk was observed for depressive symptoms, chronic stress, and hostility (all P for trend <= 0.02) but not for trait anger (P>0.10). Hazard ratios (HRs) and 95% confidence intervals indicated significantly elevated risk for the highest-scoring relative to the lowest-scoring group for depressive symptoms (HR, 1.86; 95% confidence interval, 1.16-2.96), chronic stress (HR, 1.59; 95% confidence interval, 1.11-2.27), and hostility (HR, 2.22; 95% confidence interval, 1.29-3.81) adjusting for age, demographics, and site. HRs were attenuated but remained significant in risk factor-adjusted models. Associations were similar in models limited to stroke and in secondary analyses using time-varying variables.
Conclusions-Higher levels of stress, hostility, and depressive symptoms are associated with significantly increased risk of incident stroke or transient ischemic attacks in middle-aged and older adults. Associations are not explained by known stroke risk factors.
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Details
- Title
- Chronic Stress, Depressive Symptoms, Anger, Hostility, and Risk of Stroke and Transient Ischemic Attack in the Multi-Ethnic Study of Atherosclerosis
- Creators
- Susan A. Everson-Rose - University of MinnesotaNicholas S. Roetker - University of MinnesotaPamela L. Lutsey - University of MinnesotaKiarri N. Kershaw - Northwestern UniversityW. T. Longstreth - University of WashingtonRalph L. Sacco - University of MiamiAna V. Diez Roux - University of MichiganAlvaro Alonso - University of Minnesota
- Publication Details
- Stroke (1970), v 45(8), pp 2318-2323
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 6
- Grant note
- R44HL095169 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Applied Clinical Research Program UL1RR024156 / NATIONAL CENTER FOR RESEARCH RESOURCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) N01 HC95163 / Program in Health Disparities Research at the University of Minnesota N01HC095166 / DIVISION OF EPIDEMIOLOGY AND CLINICAL APPLICATIONS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Eye Institute (NEI) P60MD002249 / National Institute on Minority Health and Health Disparities; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Minority Health & Health Disparities (NIMHD) N01-HC-95159; N01-HC-95169 / National Heart, Lung, and Blood Institute (NHLBI); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) 2P60MD002249 / Michigan Center for Integrative Approaches to Health Disparities UL1-RR-024156; UL1-RR-025005 / National Center for Research Resources (NCRR); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Drexel University
- Web of Science ID
- WOS:000340297300027
- Scopus ID
- 2-s2.0-84905375992
- Other Identifier
- 991020112285004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Peripheral Vascular Disease