Self-Perceived Psychological Stress and Risk of First Stroke in Treated Hypertensive Patients

Bibliographic Data

ID19306323
AuthorsHuan Li (0000-0003-0910-1433, Shanghai Liangyou (China)), Panpan He (0000-0003-4238-5837, Beibu Gulf University, corresponding author), Yuanyuan Zhang (0000-0001-9230-7314, Beibu Gulf University), Tengfei Lin (0000-0001-7428-9829), Teng-Fei Lin (0000-0001-5282-6945, Beibu Gulf University), Chengzhang Liu (0000-0002-8977-3370, Beibu Gulf University), Di Xie (0000-0003-3600-2983, Beibu Gulf University), Min Liang (0009-0008-3587-5639, Beibu Gulf University), Guobao Wang (0000-0003-4050-3385, Beibu Gulf University), Jing Nie (0000-0002-9116-8858, Beibu Gulf University), Yun Song (0000-0003-3941-6292, Beibu Gulf University), Lishun Liu (Beibu Gulf University), Binyan Wang (0000-0003-2082-7630, Beibu Gulf University), Yan Zhang (0000-0001-8460-2671, Beibu Gulf University), Jianping Li (0000-0003-4976-4119, Beibu Gulf University), Yong Huo (0000-0002-5407-8773, Beibu Gulf University), Xiaobin Wang (0000-0003-1738-6395, Beibu Gulf University), Fan Fan Hou (0000-0003-3117-7418, Beibu Gulf University), Xiping Xu (0000-0002-3821-9257, Beibu Gulf University, corresponding author), Xianhui Qin (0000-0001-7812-7982, Beibu Gulf University, corresponding author)
Year2022
Volume84
Issue2
Pages237-243
Publication date2022-02-01
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000001030
PMID34654026
OpenAlexW3205681719
LanguageEN
Citations received1
References cited32

OBJECTIVE: We aimed to investigate the prospective association between self-perceived psychological stress and first stroke, and to examine possible effect modifiers among adults with hypertension. METHODS: A total of 20,688 hypertensive adults with information on self-perceived psychological stress at baseline were included from the China Stroke Primary Prevention Trial. Participants were randomly assigned to a double-blind treatment of receiving a single tablet daily with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. Follow-up visits occurred every 3 months after randomization. Psychological stress was measured with a one-item 3-point rating scale. The primary outcome was first stroke (fatal or nonfatal). RESULTS: The median treatment period was 4.5 years. Compared with participants with low levels of psychological stress, those with high psychological stress had a significantly higher risk of first stroke (adjusted hazard ratio = 1.40, 95% confidence interval = 1.01 to 1.94) or first ischemic stroke (adjusted hazard ratio = 1.45; 95% confidence interval = 1.01 to 2.09). Moreover, a stronger positive relationship between psychological stress and first stroke was found in participants with time-averaged mean arterial pressure <101 mm Hg (median; p-interaction = .004) during the treatment period. However, our study did not find a significant association between psychological stress and first hemorrhagic stroke. CONCLUSIONS: Higher psychological stress was associated with an increased risk of first stroke among treated hypertensive patients, especially in those with lower mean arterial pressure during the treatment period

Blood pressure · Confidence interval · Hazard ratio · Perceived Stress Scale · Physical therapy · Prospective cohort study · Stress (linguistics) · Stroke (engine) · Cardiac Health and Mental Health · Dementia and Cognitive Impairment Research · Internal Medicine · Medicine · Stroke Rehabilitation and Recovery

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