From: Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-analysis
Author YearCountry | Quality rating | Cases: controls Type of controls | % Male | Cases: controls with stress | Stress exposure and measure | Stroke outcomes | Previous stroke excluded | Number of confounders controlled for in fully adjusted model |
---|---|---|---|---|---|---|---|---|
Risk estimates Odds Ratio (95Â % CI) | ||||||||
Age range (y) | ||||||||
Jood, 2009 [15] Sweden | 7 | 600 : 600 Population 18–69 | 64 | 126:46 | Permanent self-perceived psychological stress General stress | Non-fatal ischaemic Stroke | No | 10 |
Single question | 3.49(2.06-5.91) | |||||||
O’Donnell 2010 [16] 22 countries | 5 | 3000 : 3000 | 63 | 589:440 | Psycho-social stress General stress | Non-fatal stroke (excludes SAH) | Yes | 13 |
Hospital or community | Â | Â | Single question | 1.30(1.11-1.52) | ||||
Mean 61.1 (SD 12.7) | ||||||||
Abel, 1999 [32] USA | 5 | 655:1087 | 44.6 % cases, 39.9 % controls | Categorical boundary for stress risk factor not used so raw numbers ‘with stress RF’ not reported | 20 point increase on GSRRS 35 item Geriatric Social Readjustment Rating Scale [43] General stress | Fatal & non-fatal ischaemic stroke | Yes | 7 |
Community | ||||||||
Mean age | ||||||||
Cases 69.8 | 1.01(0.99-1.03) | |||||||
Controls 70.2 | ||||||||
Egido, 2012 [29] Spain | 6 | 150:300 | 77.3 % cases, 36.3 % controls | 62:50 (41.4 %:16.7 %) | Score > =150on Holmes & Rahe 40-item questionnaire of life events [41] | Non-fatal stroke (90 % were ischaemic) | Yes | 9 |
Population | ||||||||
8 item ERCTA (Recall Scale of Type A Behaviour [44] | ||||||||
Mean age | ||||||||
Cases 53.8 | ||||||||
3.84(1.91-7.72) | ||||||||
(SD 9.3) | ||||||||
Controls 53.6 | ||||||||
(SD 9.6) |