Global Study Finds Higher Risk of Stroke in People With Depression

Depressive symptoms are associated with not only an increased risk of stroke but also worse functional outcomes afterward, according to results from a global study published in Neurology.

“Our study provides a broad picture of depression and its link to risk of stroke by looking at a number of factors including participants’ symptoms, life choices, and antidepressant use,” said first author and stroke physician Robert P. Murphy, MBBS, of the University of Galway in Ireland. “Our results show depressive symptoms were linked to increased stroke risk and the risk was similar across different age groups and around the world.”

The INTERSTROKE study included 26,877 adults from 32 countries in North and South America, Europe, Asia, the Middle East, and Africa. Participants with stroke were matched with control subjects without stroke for age, gender, and racial/ethnic identify.

Some 18% of people who had a stroke had depressive symptoms within the last 12 months compared with 14% of control subjects who did not have a stroke, according to the study. Adjusted analysis found a 46% greater risk of stroke in people with depressive symptoms compared with people without such symptoms.

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Stroke risk was higher in participants with more depressive symptoms. Compared with no depressive symptoms, people with five or more depressive symptoms had a 54% increased risk of stroke, people with three to four had a 58% increased risk of stroke, and people with one or two had a 35% increased risk of stroke, the study found.

Depressive symptoms were not associated with worse stroke severity. However, they were linked with worse functional outcomes 1 month after the stroke compared with patients who did not have depressive symptoms, researchers reported.

“The current analysis provides deeper insights into the association of depressive symptoms with stroke risk, reporting an increased risk,” said study coauthor Martin O’Donnell, PhD, MD, professor of neurovascular medicine at the University of Galway. “These analyses suggest that effective identification and management of depression may also be associated with reduced stroke risk, although the observational nature of the study does not permit definitive conclusions.”

References

Murphy RP, Reddin C, Rosengren A, et al. Depressive symptoms and risk of acute stroke: INTERSTROKE case-control study. Neurology. Published online March 8, 2023. doi:10.1212/WNL.0000000000207093

People who have symptoms of depression may have an increased risk of having a stroke. News release. University of Galway; March 9, 2023. Accessed March 10, 2023.