Can Stress Cause a Stroke?

The topic of stress is huge in today’s society. Perhaps even YOU are dealing with stress right now in one form or another? Life’s stressors come and go and in some cases are even chronic stressors. These can have a severe impact on our health. But can stress cause a stroke?

The short answer to this question is “It’s possible”. However, it is determined by many factors- some of which you can control!

In this article, I’ll explain how stress can affect heart function, talk about types of stress, give research-based evidence on whether or not stress can cause a stroke, and provide practical tips to reduce the stress in your life.

If you’re ready to live a life of LESS stress, let’s begin…

*Note: This article contains affiliate links that are clearly marked. As an Amazon Associate, I earn from qualifying purchases.

Facts About Stress

Did you know that each year the American Psychological Association does an annual survey of over 3,000 U.S. adults to assess their perceived stress levels? They sure do. The latest survey was completed in 2023 and is quite interesting. The press release states that we are “a nation recovering from collective trauma”.

Here’s a brief list of the 2023 data on stress:

  • Every age group (other than those ages 65 and over) saw an increase in stress levels from 2019 to 2023.
  • Those ages 35 years and older had an increase in chronic illness diagnoses.
  • Two-thirds of adults ( 67%) feel their stress is not “bad enough” to stress about because others have it worse.
  • Three out of every five adults (62%) do not talk about their stress because they don’t want to burden others.
  • One-third (33%) of adults feel they are too stressed about everyday life to think about the future.
  • Those ages 35 to 44 years had the most significant increase in reported stress (from 21% in 2019 to 31% in 2023).
  • Lowest levels of stress were seen in the retired population.

According to the survey, multiple factors were causing the increase in stress over the last few years. They include:

  • Money
  • Economic concerns
  • Family responsibilities
  • Personal safety
  • Discrimination

If you’d like more information on the survey findings or want to see which questions were asked, visit the Stress in America webpage.

A Brief Physiology of Stress

There is acute stress (sudden and intense) and also chronic stress (long-term and constant). Both acute and chronic stress are detrimental to overall health. But what exactly happens inside our bodies when we experience stress that could potentially lead to a stroke?

When you think about how our bodies react under stress, it’s no surprise that it leads us into a downward spiral.

This spiral usually starts with a stressor being introduced. The series of events that follows is the scary part. Here are a few bodily changes that occur internally when we experience anxiety or a stressful event:

  1. Your central nervous system releases stress hormones- adrenaline and cortisol
  2. Heart rate, blood pressure, and blood flow increase
  3. Blood glucose levels also rise
  4. Airways begin to constrict which can lead to shortness of breath
  5. The rate at which foods move through your bowels is altered and may cause constipation or diarrhea
  6. Muscles begin to tense up

This is also called the “fight or flight” response. All of these things happen simultaneously and could lead to different types of cardiac events, including a stroke.

Types of Stroke

There are three common types of strokes associated with stress.

Ischemic stroke– this is the most common type of stroke which is when a blood vessel to the brain is obstructed.

Hemorrhagic stroke– this is also called a brain bleed and occurs when a weakened blood vessel bursts. High blood pressure can often cause a hemorrhagic stroke.

Transient ischemic stroke (TIA)– unlike an ischemic stroke, a mini-stroke (or TIA) is when there is a temporary blockage of blood flow to your brain caused by a clot. This usually resolves on its own and lasts less than 5 minutes by the clot dissolving or getting dislodged.

Keep in mind that all types of stroke are serious events that you need to get help for immediately!

The Link Between Stress and Stroke

The amount of emotional and psychosocial stress in your life may determine stroke risk and cardiovascular disease according to what limited research is available.

Emotional stress is defined as experiencing negative affect, distress, or anxiety and the physiological responses that occur, including the cardiovascular and hormonal changes I mentioned above.

The INTERSTROKE study suggests that stroke risk is higher when you are emotionally stressed because of the constriction of blood vessels which leads to higher blood pressure. This can cause plaques to rupture or lead to arrhythmias that can trigger a stroke.

This same study mentions that anger and physical exertion can also trigger a stroke.

Psychosocial stress is defined as intense stress brought on by social situations (at home or at work). Examples of psychosocial stressors include:

  • Divorce
  • Prolonged illness
  • Death of a child
  • Stressful work situations
  • Natural catastrophe

This type of stress may increase your risk of all stroke, ischemic stroke, and hemorrhagic stroke (1).

Stress of all types leads to physiological changes within our bodies. These changes can lead to cardiovascular disease if stress is long-term or in some cases lead to a stroke if stress is sudden and intense (2).

In addition, anxiety can cause your blood to coagulate or clot which may lead to deep vein thrombosis (DVT). This is because anxiety increases oxidative stress and cell damage leading to clotting of the blood (3, 4).

Both emotional and psychosocial stress can contribute to bodily changes that may lead to stroke or heart attack.

Other Factors To Consider

You also need to consider that when you are under stress, it may lead to other unhealthy lifestyle behaviors.

For example, have you ever noticed that when you are stressed you don’t sleep as well, or maybe you don’t eat a healthy diet?

The more unhealthy lifestyle habits you adapt, the higher your risk of having a stroke or heart attack.

Some unhealthy behaviors brought on by stress include:

  • Smoking or tobacco use
  • Alcohol use
  • Other substance abuse
  • Unhealthy dietary choices- including foods high in fat, sugar, and ultra-processed foods
  • Undereating or overeating
  • Disruption in sleep patterns– sleeping too much or too little
  • Decrease in physical activity
  • Lack of desire to be social or participate in activities you once did

These health-damaging behaviors are unhealthy coping mechanisms for handling stress and can lead to further issues including… you guessed it….more stress.

Related Article: Maintaining a Healthful Diet During Times of Stress

Can Stress Cause a Stroke?

Stroke can be one of many potential outcomes of intense stress.

Stress is not a direct cause of stroke, but rather an indirect result of the physiological changes your body goes through when under stress.

Changes in your pulmonary, cardiovascular, and nervous system in addition to unhealthy behaviors brought on by stressful situations can increase your risk of blood clots or bursting of blood vessels. This may lead to a stroke or a heart attack.

These occurrences are more likely to happen in those already dealing with heart disease or psychological or mental health issues.

If you have a cardiac emergency, it’s best to have a plan in place. Check out my article Reversible Causes of Cardiac Arrest: Beyond the H’s and T’s to download a free Emergency Response Plan.

What Age Group Is At Risk?

To be honest, all age groups are at risk of having a stroke due to intense stress.

Even young and middle-aged adults are at risk of having a stroke when put under large amounts of stress.

Research shows that 10%-14% of ischemic strokes occur in adults aged 18-45 years old (5).

This younger adult population is also more prone to having a “mini-stroke” or transient ischemic attack (TIA) compared to the older population.

Managing Stress to Reduce Stroke Risk

It’s incredibly important to manage and reduce your stress to reduce your stroke risk. Managing stress can reduce blood pressure, and blood sugar, and prevent all other negative changes that ensue when you are stressed out.

There are several ways you can accomplish this. Reducing stress involves lifestyle changes, stress reduction techniques, and ensuring you have good social support.

Let’s talk about each of these coping strategies to reduce stress.

Lifestyle Changes

Making healthy lifestyle changes is one way you can reduce your risk of stroke and keep stress at bay. Lifestyle changes that may help you manage stress better include:

Exercising– this is an excellent drug-free coping strategy that is also FREE. I recommend a regular walking program as a great form of physical activity for beginners.

Eating a healthy dietary pattern– eating a healthy, balanced diet can provide your body with the nutrients it needs to function properly as you heal and recover from stress. A registered dietitian can help you meet your specific dietary needs and goals.

You can find a registered dietitian near you by visiting the Academy of Nutrition and Dietetics webpage.

Avoiding tobacco, alcohol, and other drugs– these behaviors can add to the stress in your life by leading to health complications, straining personal relationships, and negatively impacting your mental and emotional state further.

Stress Reduction Techniques

These stress reduction techniques are self-help interventions that can reduce anxiety, and symptoms of depression, and improve sleep (6). They can help reduce blood pressure, and heart rate, and possibly reduce the severity of your stress response.

Mindfulness-based stress reduction (MBSR)– this technique involves training your mind to achieve a state of calm. Activities like guided meditation and yoga are examples of mindfulness techniques.

Guided imagery– this technique involves imagining peaceful scenes, scenarios, or images to promote positive feelings and emotions. Research shows that this form of therapy is an effective, inexpensive, and accessible way to manage anxiety (7).

Breathwork therapy– this type of therapy involves intentionally focusing on your breathing pattern to promote relaxation and more resilient stress response (8).

Music therapy– in this form of stress reduction, individualized music interventions are introduced by a trained and qualified music therapist and may have a moderate to large impact on stress reduction (9).

One or more of these stress reduction techniques can be used at the same time. For example, while meditating or performing yoga, focusing on breathwork and calming music is often included to help create a relaxing environment and ease stress.

Another effective stress reduction technique is coloring- as in adult coloring books. I created one just for heart patients called The Heart Health Coloring Book (affiliate link) that you can purchase on Amazon!

heart health coloring book by Kiran Campbell, RD

Social Support

Individuals who have little social support from family or friends, live in poverty, or live an isolated life may be at higher risk of stress and heart conditions (10).

When stress levels are high, social support can be an excellent coping mechanism. Talking about stressful situations with others can promote feelings of companionship and emotional support. Overall this can improve satisfaction with life (11).

However, the quality of your social support matters greatly. Some research shows that in some cases, certain types of social support can add to stress (12).

If you do not have a good social support network, you can always seek the help of a professional counselor or psychologist for stress management.

Dietary Recommendations for Stress Reduction

As I mentioned above, eating a healthy diet can act as a buffer to support overall health when you are stressed. Foods provide you with energy to function and nutrients to maintain health.

Some foods contain specific phytonutrients to help reduce stress. There are also nutritional strategies you can utilize that may help the stress response.

Foods that Promote Relaxation and Reduce Stress

Some foods known to help ease stress reduce the hormone cortisol (the stress hormone). Foods that contain polyphenols, phospholipids, probiotics, GABA, omega-3 fatty acids, or the amino acid tryptophan can also reduce cortisol levels or decrease how much is produced.

Here are a few foods that include one or more of these components:

Nutritional Strategies for Stress Management

Incorporating simple nutritional strategies into your daily lifestyle can also reduce stress and lower your risk of cardiovascular disease. Try some of these strategies the next time you experience high levels of stress:

  • Add nutrient-dense foods– when under stress you may crave unhealthy foods like convenience foods or comfort foods. These are fine in small amounts but be mindful of portions and incorporate other anti-inflammatory and nutritional foods like the ones listed above!
  • Limit processed foods and sugar– these foods can add to the inflammation already brought on by stress.
  • Don’t skip meals– continue to eat a healthy diet of at least three meals per day. Skipping meals can lead to unstable blood sugars, weakness, or overeating at your next meal.
  • Stay hydrated– dehydration can thicken your blood and make it harder for your heart to pump blood. Staying hydrated can also reduce your risk of stroke and lead to better outcomes following a stroke (13).
  • Limit caffeine– caffeine is a stimulant that can temporarily restrict blood vessels and increase blood pressure. Adding too much caffeine to a stressful situation can increase stroke risk. The FDA recommends no more than 400 milligrams of caffeine per day.

Importance of Balanced Nutrition

Following a balanced diet is important to meet your specific dietary needs. Many dietitians, myself included, like to encourage a variety of colorful foods and eating at regular intervals to help maintain energy levels, adequate blood sugars, and vital nutrients.

Research shows that specific dietary patterns like the Mediterranean diet and Green Mediterranean diet may reduce morning cortisol levels due to their high polyphenol content.

Both of these patterns focus on plant-based, whole-food sources and minimize processed foods and red meat. They also include nuts, seeds, legumes, fish, and seafood.

Other research also encourages a higher carbohydrate diet for stress reduction. According to one study, following a whole food diet like the Dietary Guidelines for Americans that allows ~305 grams of carbohydrates per day may result in lower circulating cortisol levels and reduce your stress response.

For heart-healthy recipes to reduce heart disease and stroke, visit my recipes page!

Conclusion

In conclusion, stress can most definitely lead to a possible stroke. Stress is an all-to-real aspect of modern life, affecting individuals across all age groups and backgrounds. While the link between stress and stroke is not exactly direct, what we do know helps us understand which lifestyle and dietary behaviors can help and harm our chances of leading to a stroke.

Both acute and chronic stressors contribute to physiological changes within the body, which may elevate the risk of stroke over time. Moreover, unhealthy coping mechanisms adopted under stress, such as poor dietary choices and substance abuse, further increase your risk.

However, implementing lifestyle changes, embracing stress reduction techniques, fostering social support networks, and adopting a balanced nutritional approach promotes both physical and emotional well-being. By prioritizing stress management, individuals can navigate life’s challenges with resilience and protect against heart disease for the long term.

If you or someone you know is struggling with mental health or at risk of hurting themselves or others, contact the Suicide and Crisis Lifeline — call or text 988, or chat at 988lifeline.org.

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