A recent study published in Neurology®, the journal of the American Academy of Neurology, on March 5, 2025, suggests that individuals living with chronic stress, particularly younger women, may face a heightened risk of experiencing a stroke. However, the study establishes only an association rather than causation. This research mainly focused on younger adults and revealed a noteworthy association between stress and stroke in women, with no discernible cause. At the same time, no such link was observed in male participants.
Nicolas Martinez-Majander, MD, PhD, from the Helsinki University Hospital in Finland, highlighted that young individuals frequently face stress due to various pressures related to their careers, such as extensive working hours, job insecurity, and financial concerns. Previous studies have consistently indicated that chronic stress can adversely impact both physical and mental health. The findings of this latest study suggest that such stress could be a contributing factor to stroke occurrences in younger women.
The methodology of the study involved examining 426 individuals aged between 18 and 49 who had suffered an ischemic stroke of unknown origin. These participants were paired with an equal number of individuals who had not experienced a stroke, matching them by age and gender. An ischemic stroke occurs when a blockage impedes the blood flow to a part of the brain, potentially resulting in severe outcomes such as physical weakness, speech difficulties, vision issues, or even death.
Participants had to complete a detailed questionnaire to measure stress levels over the month preceding the survey. For those who had suffered a stroke, the stress level was recorded for the month before the stroke occurred. The questionnaire consisted of 10 queries aimed at assessing their ability to manage crucial aspects of their lives, with responses ranging from zero (“never”) to four (“very often”). The total stress score was then categorised into three levels: low stress (0 to 13), moderate stress (14 to 26), and high stress (27 to 40). The results showed that stroke sufferers generally reported higher stress levels, with an average score of 13, compared to an average score of 10 in those without a stroke.
The analysis revealed that stroke patients were more likely to report moderate to high-stress levels, with 46% of stroke patients falling into these categories, as opposed to 33% of those without a stroke. After accounting for various factors that could influence stroke risk, such as educational attainment, alcohol consumption, and blood pressure, it was found that moderate stress in female participants was associated with a 78% increase in stroke risk, and high stress correlated with a 6% increase. No similar correlation was found in male participants.
Martinez-Majander stressed the need for further research to delve into the reasons why stressed women, but not men, are more susceptible to strokes and to investigate why moderate stress appears to be more significantly associated with stroke risk in women than high stress. Understanding the mechanisms by which stress influences stroke risk could pave the way for more effective prevention strategies.
However, the study’s reliability is potentially compromised by the possibility that individuals experiencing higher levels of stress might have been less inclined to participate, which could have skewed the results. More comprehensive studies are needed to confirm these findings and explore the underlying reasons for these gender differences in stress-related stroke risk.
More information: Nicolas Martinez-Majander et al, Association Between Self-Perceived Stress and Cryptogenic Ischemic Stroke in Young Adults
A Case-Control Study, Neurology. DOI: 10.1007/s00394-023-03123-x
Journal information: Neurology Provided by American Academy of Neurology
