Stressed Out? Chill Out, to Avoid Stroke

Reviewed by Jacqueline Brooks, MBBCH, MRCPsych
From the WebMD Archives

Aug. 2, 2001 -- Keeping cool in stressful situations could help you sidestep a stroke -- especially if you have high blood pressure, according to a new study.

"Hypertensive men should be informed about the stroke risks associated with getting upset," says Lena André-Petersson, MS, a researcher at the Gerontology Research Center at Göteborg University in Göteborg, Sweden. Her study appears in the new issue of the journal Stroke, published by the American Heart Association.

"We know that mental stress is associated with heart disease; it is also associated with wear and tear on the body, which in the long run can lead to disease. Of course, no one can be protected from the hardships of life, but [this study shows] it is better to think things over before you react," André-Petersson tells WebMD.

"The way in which individuals handle stress determines whether they have a stroke," she says.

Her study involving 500 men, all in their late 60s -- nearly 300 of whom had hypertension -- found that staying calm does reap lifelong benefits. In the study, the men were given a test designed to challenge their frustrations. She tracked what she calls their "stress adaptation" during the test.


The test, Andre-Petersson admits, "is a rather difficult task that anyone would find challenging and frustrating. They sigh, blush, start sweating."

In her study, those who coped well decided on a strategy early on, she says. Others tried different strategies and then just got tired of the test. Another group tried several strategies, with some success, but did not stick with the strategies that worked. They also had difficulty concentrating, she says.

For those who grew most frustrated, "the risk of stroke was significant," André-Petersson tells WebMD. In the follow-up portion of the study, they were the people more likely to have a stroke.

Such men are the type "who find all conflicts more strenuous and have to work harder than other individuals," she says. "There are many individuals like this who don't pay attention to alarming signals from the body."

"These patterns are reflections of habitual behavior, which is not easily changed," says André-Petersson. "These are probably also men who could benefit from all kinds of information about smoking, drinking, diet, blood pressure, and physical activity."


Research has indeed linked psychological stress and personality type with various medical conditions -- including heart disease and hypertension -- but not with stroke, says Allyson Zazulia, MD, assistant professor of neurology at Washington University School of Medicine in St. Louis.

"We know that elevated blood pressure is a risk factor for stroke," she tells WebMD. "People with poor stress response during this study probably had higher blood pressure, more often, on any day."

Also, under stressful situations there is an increase in the stress hormones epinephrine and norepinephrine, says Zazulia.

"We know that lowering blood pressure -- even by just a little -- cuts down on stroke risk more than anything else," she says.

"If that's possible through meditation or other relaxation methods, then those are beneficial," she tells WebMD. But, she says, people who are high risk for other medical problems because of this poor response to stress will probably do better on the appropriate medicines.

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