Higher locus of control linked to lower risk for stroke

A higher locus of control at work and home was associated with reduced psychosocial stress and lower odds of acute stroke, researchers reported in JAMA Network Open.

Psychosocial stress is considered a modifiable risk factor for stroke, and it represents a potentially active target for population-health interventions, Catriona Reddin, MB, of the HRB Clinical Research Facility at the University of Galway in Ireland, and colleagues wrote.

Researchers sought to determine the association of psychosocial stress with the risk for acute stroke, as well as explore factors that may modify the association of stress and risk for stroke.

They conducted a retrospective, case-control study of risk factors for first acute stroke in 32 countries in Asia, North and South Americas, Europe, Australia, the Middle East and Africa and recruited 13,462 patients with stroke and 13,488 matched controls.

Researchers measured psychosocial stress and occurrence of stressful life events within the preceding year through a standardized questionnaire of self-reported stress at home and work.

Of 26,812 participants analyzed, the mean age of patients with stroke was 62.2 years compared with 61.3 years for controls. Both populations had a male majority. Several periods of stress and permanent stress were reported for 20.5% of patients with stroke and 14.4% of controls.

According to results, increased stress at home (OR = 1.95; 95% CI, 1.77-2.15) and at work (OR = 2.7; 95% CI, 2.25-3.23) and recent stressful life events (OR = 1.31; 95% CI, 1.19-1.43) were associated with an increased risk for acute stroke.

Further, a higher locus of control at home was linked with reduced odds of all strokes (OR = 0.73; 95% CI, 0.68-0.79), while higher locus of control at work and at home was linked to lower odds of acute stroke and significantly reduced the association with stress at work (OR = 2.2; 95% CI, 1.88-2.58) and home (OR = 1.69; 95% CI, 1.44-1.98) for acute stroke.

“The findings of this international case-control study suggest association between psychosocial stress and stressful life events with increased risk of all stroke,” Reddin and colleagues wrote. “This association is consistent for ischemic and hemorrhagic stroke types. Locus of control and its relevant components, life control and work control, appear to be important effect modifiers.”