A study published on March 5, 2025, in Neurology®, the medical journal of the American Academy of Neurology, suggests that chronic stress could increase the risk of stroke in younger women. The study does not establish that stress directly causes strokes, but it highlights an association between the two, particularly in women aged 18 to 49.
Chronic stress, often experienced due to pressures such as work demands, long hours, job insecurity, and financial burdens, has long been known to negatively impact both physical and mental health. However, this new research brings to light the potential link between stress and ischemic stroke, a condition where blood flow to part of the brain is blocked, leading to symptoms such as weakness, speech difficulties, vision problems, or even death.
The study examined 426 individuals aged 18 to 49 who had experienced an ischemic stroke with no known cause. These individuals were matched with an additional 426 people of the same age and sex who had not had a stroke. Participants were asked to complete a questionnaire regarding their stress levels over the preceding month. The questionnaire included ten questions related to stress, such as, “In the last month, how often have you felt that you were unable to control the important things in your life?” Scores ranged from zero (not often) to four (very often). A score of 0 to 13 indicated low stress, 14 to 26 indicated moderate stress, and 27 to 40 indicated high stress.
The results showed that individuals who had suffered a stroke had higher average stress scores than those who had not. The average stress score for people with a stroke was 13, while those without a stroke had an average score of 10. In total, 46% of those who experienced a stroke reported moderate or high stress levels, compared to 33% of those who did not have a stroke.
Further analysis, taking into account potential factors such as education level, alcohol use, and blood pressure, revealed a more significant association in female participants. For women, moderate stress was linked to a 78% increased risk of stroke, while high stress was associated with a 6% increased risk. Interestingly, no such association was found between stress and stroke in male participants.
Nicolas Martinez-Majander, MD, PhD, from Helsinki University Hospital, and lead author of the study, emphasized the need for further research to understand why chronic stress appears to affect women’s stroke risk more than men’s. He also noted the surprising finding that moderate stress was linked to a higher risk of stroke in women than high stress, which warrants additional investigation.
The study’s limitations include the possibility that people experiencing higher stress levels may have been less likely to participate in the research, potentially affecting the results. Additionally, the study only establishes an association and does not prove causality between chronic stress and stroke.
The research was funded by the Helsinki and Uusimaa Hospital District, the Academy of Finland, The Finnish Medical Foundation, the Sigrid Jusélius Foundation, and Sahlgrenska University Hospital. These findings suggest the importance of understanding the role of stress in health, particularly in younger women, and the need for strategies to manage stress to potentially reduce the risk of stroke.
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