Depression
Linked To a Higher Risk for Stroke
People who report
symptoms of depression are more likely to die of stroke than
those who say they are at peace with themselves, suggests
a new study in the journal Stroke.
But it is possible
the depression is a subtle signal of a major stroke in the making,
the researchers add.
The two-decade-long
study of nearly 13,000 men, whose average age was 46 at the
start, found those who reported the most frequent symptoms of
depression were twice as likely to die of a stroke as those
who reported the fewest symptoms.
"Silent"
Stroke May Be a Factor
Some of those depressive
symptoms may have been caused by "silent strokes," tiny blood
vessel blockages or tears that can affect the brain, says study
author Brooks B. Gump, an associate professor of psychology
at the State University of New York at Oswego.
"That is a real possibility
because silent strokes, by definition, are not detectable clinically
but might well produce depression and predict fatal stroke later,"
Dr. Gump says.
By contrast, the study
found a much smaller relationship between depression and the
risk of death from heart attack or other cardiac conditions.
All the men were at
higher-than-average risk of death from both stroke and heart
disease because they had a number of risk factors.
Those risk factors
included high blood pressure, says Dr. Karen A. Matthews, a
professor of psychiatry, psychology, and epidemiology at the
University of Pittsburgh, where the study was based.
The study took into
account such risk factors, she says, adding, "We controlled
for the standard things people look for."
High
Rate of Depression, High Rate of Stroke
The 20 percent of
men who scored highest on a scale of depression were 21 percent
more likely to die of heart disease and 15 percent more likely
to die of any cause than those in the lowest 20 percent, the
study found.
But the likelihood
of dying from a stroke was much greater - 103 percent for the
20 percent of men with the highest depression ratings, compared
to those with the lowest ratings.
In general, there
was a steady increase in the incidence of death from stroke
related to a man's self-assessment of depressive symptoms.
For example, men who
were slightly depressed had more than a 20 percent risk of dying
from a stroke than those reporting no depressive symptoms.
It is not possible
to say for sure whether mini-strokes were at the root of the
problem, Dr. Matthews says. "For that we would need a clinical
trial, with periodic brain scans," she explains.
No matter the cause,
the study "suggests that clinicians should ask their patients
about depression," she notes.
"When people feel
depressed they should be considered for treatment, pharmaceutical
or behavioral."
Always consult your
physician for more information.
Online
Resources
(Our Organization
is not responsible for the content of Internet sites.)
American
Psychoanalytic Association
American
Psychological Association
Centers
for Disease Control and Prevention (CDC)
National
Institute of Mental Health
National
Institute of Neurological Disorders and Stroke
National
Institutes of Health (NIH)
National
Library of Medicine
US
Department of Health and Human Services |
January
2005
"Silent"
Stroke May Be a Factor
High
Rate of Depression, High Rate of Stroke
Stroke
Risk Factors Explained
Online
Resources
Stroke
Risk Factors Explained
Risk factors for stroke
that can be changed, treated, or medically managed:
-
high blood pressure
The most important controllable risk factor for brain
attack is controlling high blood pressure.
-
diabetes mellitus
Diabetes is treatable, but having it increases the risk
for stroke.
-
heart disease
Heart disease is the second most important risk factor
for stroke, and the major cause of death among survivors
of stroke.
-
cigarette smoking
Cigarette smoking greatly increases stroke risk.
-
history of transient
ischemic attacks (TIAs)
A person who has had one (or more) TIA is almost
10 times more likely to have a stroke than someone of
the same age and sex who has not had a TIA.
-
high red blood cell
count
A moderate increase in the number of red blood cells thickens
the blood and makes clots more likely, thus increasing
the risk for stroke.
-
high blood cholesterol
and lipids
High blood cholesterol and lipids increase the
risk for stroke.
-
lack of exercise,
physical inactivity
Lack of exercise and physical inactivity increases the
risk for stroke.
-
obesity
Excess weight increases the risk for stroke.
-
excessive alcohol
use
More than two drinks per day raises blood pressure, and
binge drinking can lead to stroke.
-
drug abuse (certain
kinds)
Intravenous drug abuse carries a high risk of
stroke from cerebral embolisms (blood clots).
-
abnormal heart rhythm
Various cardiac diseases have been shown to increase the
risk of stroke. Atrial fibrillation is the most powerful
and treatable cardiac precursor of stroke.
-
cardiac structural
abnormalities
New evidence shows that cardiac structure abnormalities
including patent foramen ovale and atrial septal aneurysm
increase risk for embolic stroke.
Risk factors for stroke
that cannot be changed:
-
age
For each decade of life after age 55, the chance
of having a stroke more than doubles.
-
race
African-Americans have a much higher risk of
death and disability from a stroke than Caucasians, in
part because the African-American population has a greater
incidence of high blood pressure.
-
diabetes
Diabetes is strongly linked with high blood pressure
and, although diabetes is a treatable condition, increases
a person's risk for stroke.
-
history of prior
stroke
The risk of stroke for someone who has already had one
is many times that of a person who has not had a stroke.
-
heredity/genetics
The chance of stroke is greater in people who have a family
history of stroke.
Always consult your
physician for more information. |
