Stress Linked to Stroke

Type A Personality Traits Boost Stroke Risk in Study

Medically Reviewed by Louise Chang, MD on August 30, 2012

Aug. 30. 2012 -- Need another reason to take life in stride and heed the advice, "Don’t sweat the small stuff"?

New research shows that people who are quick-tempered, impatient, aggressive, or naturally hostile may be more likely to have a stroke, compared to their more laid-back counterparts.

Having these type A personality traits was associated with a two-fold increase in stroke risk in the Spanish study, published this week in the Journal of Neurology, Neurosurgery and Psychiatry.

Living with chronic stress increased stroke risk almost four-fold.

Stress is a well-recognized risk factor for heart attack, but the study is among the first to suggest a direct impact on stroke.

The Stress, Stroke Link

“Our findings indicate that people can lower their stroke risk by attempting to reduce the stress in their lives,” says researcher Ana Maria Garcia, MD, of the Hospital Clinico Universitario San Carlos in Madrid.

The study included 150 people who'd had strokes and 300 randomly selected people who had not had strokes.

The average age of the participants was 54, which is much younger than the typical stroke patient.

Garcia says that studying the impact of stress on stroke was easier in younger people who'd had strokes because they were less likely to have health issues like high blood pressure that have been linked to stroke.

All the participants were assessed for these known stroke risk factors. They were also asked about life stressors and other lifestyle factors that may impact stroke risk, such as alcohol use, coffee and energy drink use, and smoking history.

Stroke Risk Higher in Chronically Stressed

Among the findings:

  • Experiencing a major life event over the previous eight months resulting in chronic stress was a strong risk factor for stroke.
  • Having a type A personality, being a current or past smoker, and drinking two or more energy drinks a day doubled the odds of stroke.
  • Having a heart rhythm disorder and being excessively sleepy during the day (which is a leading symptom of sleep apnea) were both associated with a three-fold increase in risk.

Chronic stress and having a type A personality remained strong risk factors for stroke even after the researchers considered the impact of these other known or suspected risk factors.

Stroke specialist Rafael Ortiz, MD, says the new research adds to the evidence that stress is a strong risk factor for stroke.

Ortiz directs the Center for Stroke and Neuro-Endovascular Surgery at Lenox Hill Hospital in New York City.

‘Stress Unavoidable in Real World’

Ortiz says that known risk factors for stroke include high blood pressure, high cholesterol, obesity, diabetes, artery disease, heart disease, and smoking.

“This study gives us another reason to counsel patients with these risk factors to try and reduce the stress in their lives,” he says.

Larry B. Goldstein, MD, who directs the Duke Stroke Center at Duke University Medical Center, says that although that is good advice, it may not be so easy to follow.

“Everybody would be better off living a stress-free life, but we live in the real world,” he says.

Goldstein, who is a spokesman for the American Heart Association, says although studies suggest that lifestyle factors like stress, alcohol use, and even drinking energy drinks have a direct impact on stroke risk, proving these associations is difficult.

“Showing an association is not the same thing as showing causality,” he says.

Show Sources


Egido, J.A., Journal of Neurology, Neurosurgery and Psychiatry, Aug. 29, 2012.

Ana Maria Garcia, MD, Stroke Unit, Department of Neurology, Hospital Clinico Universitario San Carlos, Universidad Complutense de Madrid, Madrid, Spain.

Rafael Ortiz, MD, director, Stroke and Neuro-Endovascular Surgery, Lenox Hill Hospital, New York City, N.Y.

Larry B. Goldstein, MD, director, Duke Stroke Center, Duke University Medical Center, Durham, N.C.

News release, BMJ Group.

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