A recent study has revealed a strong correlation between stress and the risk of early-onset cryptogenic ischemic stroke (CIS), a type of stroke that occurs when a blood clot obstructs blood flow to the brain without an identifiable cause, primarily affecting younger individuals.

Key Findings of the Study

Published in Neurology on March 5, the study underscores stress as a significant yet often overlooked risk factor, particularly among women. The research analyzed data from over 500 participants under 50 who had suffered from cryptogenic ischemic strokes, alongside a control group of healthy individuals.

Conducted across 19 centers in Europe, the study employed the Perceived Stress Scale (PSS) to assess stress levels and explore biological and lifestyle factors contributing to stroke risk. Results showed that individuals experiencing moderate to high self-perceived stress had a greater likelihood of suffering from early-onset CIS. Even after adjusting for conventional risk factors—such as hypertension, diabetes, smoking, and a sedentary lifestyle—stress remained a strong independent predictor.

Impact of Stress on Different Groups

Sex-specific analysis indicated that women with moderate to high stress levels remained at increased risk of CIS even after adjusting for other health factors. Among men, however, the association weakened once vascular risk factors were considered, suggesting that lifestyle choices may play a more substantial role in stroke risk for men.

Age-group analysis further highlighted that stress had a more significant impact on younger adults (18–39 years old). For individuals aged 40–49, the correlation weakened once vascular factors were taken into account, suggesting that stress is a more dominant risk factor for strokes in younger populations.

How Stress Contributes to Stroke Risk

Experts believe that chronic stress increases stroke risk through several mechanisms, including elevated levels of cortisol and stress-related hormones, which contribute to inflammation, blood vessel dysfunction, and heightened clot formation. Stress may also indirectly increase the risk of stroke by promoting unhealthy behaviors, such as poor diet, lack of physical activity, and substance abuse.

The study’s researchers emphasize the need to recognize stress as a serious health risk, urging medical professionals to adopt a more integrated approach that considers both mental and physical health. Despite the strong correlation between stress and CIS, the study acknowledges its limitations, particularly the reliance on self-reported stress levels, which may introduce bias. Further research is needed to determine whether stress-management interventions can directly reduce stroke incidence.

The Broader Mental Health Context in Rwanda

In Rwanda, mental health awareness is growing, yet cultural barriers still prevent many from seeking psychological support. The 2023 Rwanda Mental Health Survey (RMHS) found that mental health conditions, including depression, anxiety, and trauma, are prevalent among the youth, affecting 10.2% to 20% of individuals aged 14 to 25.

Identifying and Managing Stress

According to Jane Abatoni Gatete, Executive Secretary of ARCT-RUHUKA, stress often arises when demands exceed an individual’s coping capacity. She distinguishes between positive stress (eustress), which can motivate productivity, and negative stress, which leads to physical and emotional distress. Symptoms of chronic stress include headaches, muscle tension, dizziness, weakened immunity, high blood pressure, sleep disturbances, and loss of appetite.

Gatete also highlights common stressors in Rwanda, such as gender-based violence, poverty, work-life balance challenges, cultural expectations regarding marriage and childbirth, and financial dependence. Exposure to abusive relationships further exacerbates stress, keeping individuals in a constant state of psychological distress.

Seeking professional counseling can provide effective coping strategies to mitigate stress. Gatete urges individuals to recognize stress as a treatable condition and seek support before it leads to severe health complications.

Expert Advice on Managing Stress

Dr. Celestin Mutuyimana, a psychotherapist at Baho Smile Institute, emphasizes that stress is a natural part of life but can become harmful when chronic. He compares stress to a guitar string—neither too loose nor too tight produces the best results. Chronic stress, lasting for extended periods and interfering with daily life, can lead to severe health consequences.

To prevent distress, Dr. Mutuyimana advises practicing effective time management, maintaining a balanced lifestyle, and engaging in enjoyable activities. He also encourages setting realistic expectations, accepting that not everything goes as planned, and seeking professional help when needed.

As stress increasingly emerges as a critical determinant of cerebrovascular health, addressing it proactively could play a vital role in preventing strokes, particularly among younger individuals.