Psychosocial Factors and Risk of Stroke

Stroke remains a leading cause of mortality and long-term disability worldwide, and a growing body of evidence highlights the contribution of psychosocial factors to its onset and progression. Chronic stress, depression and social isolation have been shown to interact with traditional vascular risk factors through both behavioural pathways, such as poor adherence to treatment and unhealthy lifestyle choices, and physiological mechanisms, including dysregulation of the hypothalamic–pituitary–adrenal axis and heightened inflammatory responses. Work-related stress and low social support further compound risk by promoting neuroendocrine changes that predispose to endothelial dysfunction and thrombosis. Recognition of these influences has prompted the development of integrated risk-assessment tools and the incorporation of stress-management and psychological screening into primary and secondary prevention programmes. Interventions targeting resilience, cognitive-behavioural coping strategies and community engagement show promise in reducing stroke incidence at the population level and offer avenues for personalised prevention in high-risk groups.

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Psychosocial Factors and Risk of Stroke publication trend

The graph below shows the total number of articles in psychosocial factors and risk of stroke across all publications each year (not limited to Nature Index journals).

Technical terms

Psychosocial stress: The experience of perceived pressure or strain arising from social or environmental demands exceeding an individual’s coping capacity.

Depressive symptoms: Clinical features such as persistent low mood, loss of interest, fatigue and cognitive disturbances indicative of depression.

Ischaemic stroke: Cerebral infarction resulting from an arterial blockage that impedes blood flow to specific brain regions.

Hazard ratio: A statistic expressing the rate at which a particular event occurs in one group relative to another over time.

Odds ratio: A measure of association representing the odds of an outcome occurring in the presence of a given exposure compared with its absence.

References

1. Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-analysis. BMC Neurology (2015).
2. Changes in Depressive Symptoms and Incidence of First Stroke Among Middle‐Aged and Older US Adults. Journal of the American Heart Association (2015).
3. Prospective association between depressive symptoms and stroke risk among middle-aged and older Chinese. BMC Psychiatry (2021).
4. Social Determinants of Stroke as Related to Stress at Work among Working Women: A Literature Review. Stroke Research and Treatment (2012).
5. A Scoping Review of Non-Pharmacological, Non-Surgical Secondary Prevention Strategies in Ischaemic Stroke and TIA in National Stroke Guidelines and Clinical Audit Documents. Healthcare (2022).