Anxiety and the Risk of Stroke: The Rotterdam Study. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Portegies, Marileen L.P.; Bos, Michiel J.; Koudstaal, Peter J.; Hofman, Albert; Tiemeier, Henning W.; Ikram, M. Arfan
• Is Part Of: Stroke. Volume 47:Issue 4(2016)
• Publication Date: 2016-04
• Subjects: anxiety -- epidemiology -- stroke; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.115.012361
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: It is unclear whether anxiety is a risk factor for stroke. We assessed the association between anxiety and the risk of incident stroke. Methods—: This population-based cohort study was based on 2 rounds of the Rotterdam Study. Each round was taken separately as baseline. In 1993 to 1995, anxiety symptoms were measured using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A). In 2002 to 2004, anxiety disorders were assessed using the Munich version of the Composite International Diagnostic Interview. Participants were followed up for incident stroke until January 2012. Results—: In the sample undergoing HADS-A (N=2625; mean age at baseline, 68.4 years), 332 strokes occurred during 32 720 years of follow-up. HADS-A score was not associated with the risk of stroke during complete follow-up (adjusted hazard ratio, 1.02; 95% confidence interval, 0.74–1.43; for HADS-A≥8 compared with HADS-A <8), although we did find an increased risk after a shorter follow-up of 3 years (adjusted hazard ratio, 2.68; 95% confidence interval, 1.33–5.41). In the sample undergoing the Munich version of the Composite International Diagnostic Interview (N=8662; mean age at baseline, 66.1 years), 340 strokes occurred during 48 703 years of follow-up. Participants with any anxiety disorder had no higher risk of stroke than participants without anxiety disorder (adjusted hazard ratio, 0.95; 95% confidence interval, 0.64–1.43). We also did not observe an increased risk of stroke for the different subtypes of anxiety. Conclusions—: Anxiety disorders were not associated with stroke in our general population study. Anxiety symptoms were only related to stroke in the short term, which needs further exploration. Abstract : Supplemental Digital Content is available in the text.