Worry can make strokes fatal

Men who suffer from depression and anxiety are more than three times as likely to die from a stroke as other men, British researchers say.

But depressed and anxious men are not much more likely to have non-fatal strokes, Margaret May and colleagues at the University of Bristol reported.

Her team studied 2124 men aged 49 to 64 who were followed for 14 years. They all lived in south Wales.

"The men who had strokes also showed a tendency to report more symptoms of anxiety and depression," they wrote in the American Heart Association journal Stroke.

They found the men with depression or similar mental illness were much more likely to have fatal strokes, although the men who did not die from their strokes were very slightly more likely to have depression.

"The study is one of the largest and best-designed studies that link depression to mortality," said Robert Carney, a professor of medical psychology at the Washington University School of Medicine in St Louis.

Of the 2000 men, 137 had strokes and 17 men died from them. Men who had strokes were also more likely to be older, heavier, to smoke and to have higher blood pressure.

The worse the depression and anxiety, the higher the risk of a fatal stroke, Margaret May's team reported.

Professor Carney, who has been studying links between depression and heart attack, said the findings were similar to his.

He said there could be several explanations. "Depressed people often don't take medicines as prescribed, so some of the men may not be taking medicines for high blood pressure, thereby increasing their risk for stroke."

There could also be physical changes in the autonomic nervous system, which controls heart rate and the contraction of blood vessels. Such changes have been seen in depression and could contribute to the severity of stroke or heart attack, he said, but added that these potential factors needed study.

Whatever the cause, Professor Carney said, doctors needed to take more care to screen their patients for mental illness.

"These findings suggest that ignoring depression and anxiety is probably not good medical practice," he said.

Stroke is the third leading cause of death in the US, after heart disease and cancer.

About 600,000 Americans have a stroke every year, and 167,000 die from it, statistics from the American Heart Association suggest.

- REUTERS

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