Psychological distress increases risk of death from stroke

Psychological distress includes factors such as anxiety, depression, sleeping problems, and loss of confidence, and is common in approximately 15-20% of the general population.

While there is evidence linking psychological distress to coronary artery disease, there is a dearth of data linking psychological distress with the risk of death from stroke and other cerebrovascular diseases. Researchers from UCL sought to understand this link and looked at data from a large study of 68,652 men and women who participated in the Health Survey for England. The mean age of participants was 54.9 years of age, 45% were male and 96.1% were white.

To measure psychological distress, they used the General Health Questionnaire (GHQ-12), a widely used measure in population studies. Psychological distress was evident in 14.7% of participants and those reporting distress were younger, more likely to be female, to be from lower income groups, to smoke and use hypertension medications. Over an average 8.1 years of follow up, there were 2,367 deaths from cardiovascular disease (1,010 of these from ischemic heart disease, 562 from cerebrovascular disease and 795 from other cardiovascular-related deaths).

"Psychological distress was associated with death from cardiovascular disease, and the relation remained consistent for specific disease outcomes, including ischemic heart disease and cerebrovascular disease," writes Dr. Mark Hamer, of UCL Epidemiology & Public Health, with co-authors.

"We saw an association between psychological distress and risk of cerebrovascular disease among our participants, all of whom had been free from cardiovascular disease at baseline," state the authors. "This association was similar in size to the association between psychological distress and ischemic heart disease in the same group."

The researchers suggest that questionnaires could be useful screening tools for common mental illnesses to help reduce risk factors for death from cardiovascular disease.