Anxiety and the Risk of Stroke: The Rotterdam Study

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...

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Veröffentlicht in:	Stroke (1970) 2016-04, Vol.47 (4), p.1120-1123
Hauptverfasser:	Portegies, Marileen L.P, Bos, Michiel J, Koudstaal, Peter J, Hofman, Albert, Tiemeier, Henning W, Ikram, M Arfan
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Sprache:	eng
Schlagworte:	Aged Anxiety Disorders - complications Anxiety Disorders - epidemiology Female Follow-Up Studies Humans Incidence Male Middle Aged Prevalence Risk Stroke - epidemiology Stroke - etiology
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container_title	Stroke (1970)
container_volume	47
creator	Portegies, Marileen L.P Bos, Michiel J Koudstaal, Peter J Hofman, Albert Tiemeier, Henning W Ikram, M Arfan
description	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
doi_str_mv	10.1161/STROKEAHA.115.012361
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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.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.115.012361</identifier><identifier>PMID: 26883500</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Aged ; Anxiety Disorders - complications ; Anxiety Disorders - epidemiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Risk ; Stroke - epidemiology ; Stroke - etiology</subject><ispartof>Stroke (1970), 2016-04, Vol.47 (4), p.1120-1123</ispartof><rights>2016 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3051-d857029cb53110c3eb7c63461d8b8585798a92ee0ebbad397cd960dbfc0644a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26883500$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Portegies, Marileen L.P</creatorcontrib><creatorcontrib>Bos, Michiel J</creatorcontrib><creatorcontrib>Koudstaal, Peter J</creatorcontrib><creatorcontrib>Hofman, Albert</creatorcontrib><creatorcontrib>Tiemeier, Henning W</creatorcontrib><creatorcontrib>Ikram, M Arfan</creatorcontrib><title>Anxiety and the Risk of Stroke: The Rotterdam Study</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>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.</description><subject>Aged</subject><subject>Anxiety Disorders - complications</subject><subject>Anxiety Disorders - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Risk</subject><subject>Stroke - epidemiology</subject><subject>Stroke - etiology</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kFFPwjAUhRujEUT_gTF79GV4265d69tCUIwkJIDPS9d2YbIxXLcg_96SKY8-3Zx7zzk3-RC6xzDGmOOn1Xq5eJ8ms8RLNgZMKMcXaIgZicKIE3GJhgBUhiSScoBunPsEAEIFu0YDwoWgDGCIaLL7Lmx7DNTOBO3GBsvCbYM6D1ZtU2_tc7A-7eq2tY1Rld925niLrnJVOnv3O0fo42W6nszC-eL1bZLMQ02B4dAIFgOROmMUY9DUZrHmNOLYiEwwf5RCSWIt2CxThspYG8nBZLkGHkWK0BF67Hv3Tf3VWdemVeG0LUu1s3XnUhzHMcSMgfTWqLfqpnausXm6b4pKNccUQ3rClZ5xecnSHpePPfx-6LLKmnPoj483iN5wqEuPwG3L7mCbdGNV2W7-7_4BHiB2ZA</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Portegies, Marileen L.P</creator><creator>Bos, Michiel J</creator><creator>Koudstaal, Peter J</creator><creator>Hofman, Albert</creator><creator>Tiemeier, Henning W</creator><creator>Ikram, M Arfan</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201604</creationdate><title>Anxiety and the Risk of Stroke: The Rotterdam Study</title><author>Portegies, Marileen L.P ; Bos, Michiel J ; Koudstaal, Peter J ; Hofman, Albert ; Tiemeier, Henning W ; Ikram, M Arfan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3051-d857029cb53110c3eb7c63461d8b8585798a92ee0ebbad397cd960dbfc0644a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Anxiety Disorders - complications</topic><topic>Anxiety Disorders - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Risk</topic><topic>Stroke - epidemiology</topic><topic>Stroke - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Portegies, Marileen L.P</creatorcontrib><creatorcontrib>Bos, Michiel J</creatorcontrib><creatorcontrib>Koudstaal, Peter J</creatorcontrib><creatorcontrib>Hofman, Albert</creatorcontrib><creatorcontrib>Tiemeier, Henning W</creatorcontrib><creatorcontrib>Ikram, M Arfan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Portegies, Marileen L.P</au><au>Bos, Michiel J</au><au>Koudstaal, Peter J</au><au>Hofman, Albert</au><au>Tiemeier, Henning W</au><au>Ikram, M Arfan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anxiety and the Risk of Stroke: The Rotterdam Study</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2016-04</date><risdate>2016</risdate><volume>47</volume><issue>4</issue><spage>1120</spage><epage>1123</epage><pages>1120-1123</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><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><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>26883500</pmid><doi>10.1161/STROKEAHA.115.012361</doi><tpages>4</tpages></addata></record>
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source	MEDLINE; American Heart Association; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects	Aged Anxiety Disorders - complications Anxiety Disorders - epidemiology Female Follow-Up Studies Humans Incidence Male Middle Aged Prevalence Risk Stroke - epidemiology Stroke - etiology
title	Anxiety and the Risk of Stroke: The Rotterdam Study
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