HealthDay News — Stress, hostility, and depressive symptoms in middle-aged and older patients are associated with increased risk of incident stroke and transient ischemic attack, according to researchers.

“Stress and negative emotions, including depression, anger, and hostility, adversely affect cardiovascular disease morbidity and mortality,” explained Susan A. Everson-Rose, PhD, MPH, of the University of Minnesota in Minneapolis, and colleagues. “Less is known about their impact on stroke risk.”

Chronic stress, depressive symptoms, trait anger, and hostility and their correlation with incident stroke and transient ischemic attacks were assessed in 6,749 patients aged 45 to 84 years.

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There were 195 incident events (147 strokes and 48 transient ischemic attacks) during a mean follow-up of 8.5 years. There was a gradient of increased risk for depressive symptoms, chronic stress, and hostility (P≤0.02 for all), but no increasing risk for trait anger (P>0.10).

After adjustment for age, demographics, and site, for the highest scoring versus the lowest scoring group, risk was significantly elevated for depressive symptoms (hazard ratio, 1.86), chronic stress (HR, 1.59) and hostility (HR, 2.22).

In risk-factor adjusted models, hazard ratios were attenuated but still significant. In models limited to stroke and in secondary analyses using time-varying variables, associations were similar.

“Higher levels of stress, hostility, and depressive symptoms are associated with significantly increased risk of incident stroke or transient ischemic attacks in middle-aged and older adults,” wrote the researchers.