Type A Personality and High Stress Are Associated with Stroke

by Dr Sam Girgis on August 30, 2012

The type A personality is characterized by anger, aggression, impatience, and hostility. In contrast, the type b personality is characterized by a care free and easy going demeanor. Previous studies have shown an association between type A personality and the risk of developing coronary artery disease, also known as heart disease. This association has been disputed but the elements of type A personality disorder, such as anger, hostility, and aggression, has been shown to raise blood pressure and catecholamine levels and indirectly serve to increase risk of heart disease. In addition, certain key life events, such as loss of a loved one or bankruptcy, have been associated with increased risk of developing coronary artery disease. The link between stressful life events and type A personality disorder and stroke is less well defined.

Researchers, led by Dr. Jose Antonio Egido of the Hospital Clinico Universitario San Carlos in Madrid, Spain, have found that stressful life events as well as type A personality are associated with increased risk of developing stroke. The results of their research were published online in the Journal of Neurology, Neurosurgery, and Psychiatry. The researchers performed a case control study involving 150 patients admitted to their stroke unit and 300 normal comparisons. The researchers found that study participants with type A personality had 2.2 times the chance of having a stroke when compared to less aggressive personalities. In addition, study participants with stressful life events in the past year had 3.8 times the chance of having a stroke when compared to controls.

The authors wrote, “The grade of stress under which an individual lives is influenced by several socio-cultural factors. In the present study various dimensions of validated scales were applied, and the results are coherent in terms of relationship of stroke with stress… Individuals having lived under stressful conditions in the previous year (H&R scale) were, following adjustment, 3.8-fold more likely to suffer a stroke compared to controls… We found that individuals with high levels of competitiveness and aggression (ERCTA scale >24) are, following adjustment, 2.2-fold more likely to suffer a stroke compared with controls”.

The authors concluded, “Psycho-physical stress factors related to stressful life-style and type A personality are associated with stroke, independently of other risk factors and unhealthy life style. We did not observe gender having a significant effect on these findings of psychophysical stress and stroke. Addressing the influence of psychophysical factors on stroke could constitute an additional therapeutic line in the primary prevention of stroke in the at-risk population and, as such, warrants further investigation”.

This study has shown that stressful life event and type A personality can not only be associated with cardiovascular disease but also cerebrovascular disease. Stress elimination techniques could be one way to decrease the risk of stroke as evidenced by the results of this study. This could have great public health implications because stroke is a major cause of morbidity and mortality in today’s society.



Jose Antonio Egido et al. “Is psycho-physical stress a risk factor for stroke? A case-control studyJ Neurol Neurosurg Psychiatry published online first August 27, 2012 doi:10.1136/jnnp-2012-302420

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