A stroke occurs when the blood supply to part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. This can be due to a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). A stroke is a medical emergency that requires immediate treatment to minimize brain damage. Having one stroke puts you at increased risk for having another stroke. But can stress play a role in increasing that risk? Let’s take a closer look.
What is stress?
Stress is your body’s response to perceived threats or demands. When you feel stressed, your body goes into “fight or flight” mode, releasing hormones like adrenaline and cortisol. This causes physical changes like increased heart rate, rapid breathing, and tightening of muscles. Stress can be triggered both by physical threats (like injury or illness) and psychological threats (like work deadlines or relationship issues).
Stress is often grouped into two categories:
Acute stress – This is short-term stress that goes away quickly once the perceived threat passes. For example, feeling stressed about an upcoming work presentation.
Chronic stress – Ongoing, unrelenting stress that persists over longer periods of time. For example, financial struggles or a dysfunctional work environment.
Chronic stress is associated with increased health risks, including heart disease, high blood pressure, diabetes, and stroke.
How stress affects your body
When you experience stress, your body’s sympathetic nervous system activates the “fight or flight” response. Hormones like adrenaline and cortisol are released, causing a cascade of physiological changes, including:
- Increased heart rate and blood pressure
- Increased breathing rate to deliver more oxygen to muscles
- Release of glucose for a boost of energy
- Increased muscle tension
- Slowed digestion
This stress response evolved to help us react to immediate physical threats. However, chronic stress keeps the body in a near-constant state of activation, even without real danger. Prolonged exposure to stress hormones takes a toll on the body, putting strain on the cardiovascular system.
How stress is linked to stroke risk
There are a few key ways chronic stress can increase your risk of having a stroke:
High blood pressure
When stress hormones cause repeated blood pressure spikes, the arteries and blood vessels come under increased pressure. Over time, chronic stress can cause arterial damage and increase the hardness of vessel walls. This contributes to high blood pressure (hypertension), a major risk factor for stroke.
Atherosclerosis
Chronic stress fuels inflammation in the body, which can cause fatty deposits to build up on artery walls (atherosclerosis). These fatty plaques can block blood flow and rupture, leading to blood clots that can trigger ischemic strokes.
Unhealthy behaviors
People dealing with high stress levels may turn to unhealthy coping mechanisms like smoking, poor eating habits, lack of exercise, and excessive alcohol use. All of these behaviors can indirectly increase stroke risk.
Mental health disorders
Chronic stress is linked to mental health conditions like depression and anxiety disorder. These are associated with higher stroke risk, partly due to increased inflammation, poor health behaviors, and side effects of psychiatric medications in some cases.
Can stress trigger a second stroke?
For someone who has already had one stroke, stress may further amplify their risk for having a subsequent stroke. Here’s why:
Greater stroke vulnerability
After an initial stroke, the brain is more vulnerable to having another stroke. Even a minor stress response could reduce blood flow enough to impact damaged areas of the brain.
Stroke risk factors persist
Many underlying stroke risk factors like hypertension and atherosclerosis persist after a first stroke. Chronic stress can exacerbate these existing issues.
Post-stroke complications
Following a stroke, stress hormones released during the recovery period can interfere with the brain’s ability to heal, increasing inflammation. Stress can also impede rehabilitation efforts.
Depression risk
A stroke dramatically increases risk of depression, which is linked to higher rates of recurrence. Chronic stress and depression can combine to further impede recovery.
So in those with a prior stroke, the impact of chronic stress on the brain and body may be sufficient to trigger a subsequent stroke.
Stress management techniques
Given the potential impact of chronic stress on stroke risk and recovery, stress management is extremely important. Here are some effective strategies:
Relaxation practices
Techniques like deep breathing, meditation, yoga, and tai chi activate the body’s relaxation response, lowering blood pressure and heart rate.
Exercise
Regular moderate exercise helps burn off excess stress hormones and increases endorphins to elevate mood naturally.
Healthy lifestyle
Eating a nutritious diet, getting enough sleep, avoiding smoking/excessive alcohol can all help manage stress.
Social support
Close relationships with friends and family can act as a buffer against stress.
Professional help
If self-help tips aren’t relieving stress, seeking counseling or therapy can provide extra support. Medications may also be warranted in some cases.
The takeaway
In conclusion, chronic stress has wide-ranging effects on the body that can directly raise stroke risk in several ways. There is substantial evidence that chronic stress can contribute to first-time strokes. For stroke survivors, managing stress is an especially critical component of secondary stroke prevention and recovery efforts. Implementing regular stress relief techniques can help minimize its impacts. But seeking professional help is advisable if stress becomes overwhelming. By learning to effectively cope with stress, you can potentially lower your stroke risk and facilitate healing after a stroke.
References
- Stroke Association. Stress, anxiety and stroke. Accessed January 2023. https://www.stroke.org.uk/resources/stress-anxiety-and-stroke
- Hackett ML, Köhler S, O’Brien JT, Mead GE. Neuropsychiatric outcomes of stroke. The Lancet Neurology. 2014 May 1;13(5):525-34.
- Eurelings LS, Richard E, Eikelenboom P, van Gool WA, Moll van Charante EP. Low-grade inflammation differentiates between symptoms of apathy and depression in stroke patients. International Journal of Geriatric Psychiatry. 2015 Aug;30(8):841-7.
- Towfighi A, Ovbiagele B, El Husseini N, Hackett ML, Jorge RE, Kissela BM, Mitchell PH, Skolarus LE, Whooley MA, Williams LS. Poststroke depression: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2017 Dec;48(12):e30-43.
- American Psychological Association. Stress effects on the body. Accessed January 2023. https://www.apa.org/topics/stress/body
- Mayo Clinic. Chronic stress puts your health at risk. Accessed January 2023. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037
- Hackett ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. International Journal of Stroke. 2014 Dec;9(8):1017-25.
- Stress Management. Medline Plus. Updated January 3, 2023. https://medlineplus.gov/ency/article/002165.htm