Anxiety linked to higher long-term risk of stroke

The greater your anxiety level, the higher your risk of having a stroke, according to new research published in the American Heart Association journal Stroke.

The study is the first in which researchers linked anxiety and stroke independent of other factors such as depression. Anxiety disorders are one of the most prevalent mental health problems. Symptoms include feeling unusually worried, stressed, nervous or tense.

Over a 22 year period, researchers studied a nationally representative group of 6,019 people 25-74 years old in the first National Health and Nutrition Examination Survey (NHANES I).

Participants underwent an interview and took blood tests, medical examinations and completed psychological questionnaires to gauge anxiety and depression levels.

Researchers tracked strokes through hospital or nursing home reports and death certificates. After accounting for other factors, they found that even modest increases in anxiety were associated with greater stroke risk.

People in the highest third of anxiety symptoms had a 33 percent higher stroke risk than those with the lowest levels.

Even a minor stroke might lead to stress and anxiety

A stroke, or brain attack, is caused by bleeding inside the head or sudden loss of blood flow to the brain. A stroke can cause brain cells to die, so a person with a stroke might have paralysis, loss of feeling, speech problems, or memory and reasoning problems. The damage left by a stroke might also cause emotional problems such as depression. In this issue of Neurology, researchers in Switzerland1 looked for evidence that people who have had a stroke might have anxiety. Specifically, these researchers wanted to know whether living through the experience of a stroke might have caused an anxiety problem called posttraumatic stress disorder, or PTSD. This is a condition that can happen after a life-threatening or traumatic event, when the person feels as though he or she is re-experiencing the event. Usually the person does not want to think about what happened because it makes him or her feel numb or nervous and uncomfortable. More information about PTSD can be found on the next page.

How could a stroke cause PTSD?

The researchers had the idea that even a minor stroke could be a frightening enough event to result in PTSD. The researchers thought that if people did not know what was happening to them when they had a stroke, and if they reacted strongly with fear or worry, they might have some nervous anxiety about the stroke. Also, the researchers thought that if patients did not remember exactly what happened, or if they were not aware of the cause of their stroke, they might have more fear and worry about it. These ideas were put to the test in this research.