SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neuroepidemiology
Self-Perceived Stress and Risk of Ischemic Stroke: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Chaoyang Central Hospital, Chaoyang, China
- 2Dalian University, Dalian, Liaoning Province, China
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Word count: 232 Background:An increasing body of research indicates that psychological stress is a contributing factor to stroke.Nonetheless, the correlations between self-assessed stress and stroke remain ambiguous. We performed the first meta-analysis on the correlation between self-perceived stress and stroke risk,establishing a clear relationship between self-perceived stress and stroke.Methods: Two reviewers independently searched electronic databases (PubMed, EMBASE, SCOPUS, and the Cochrane Library) for stroke and self-perceived stress studies.Studies employing the Perceived Stress Scale (PSS) ,Single question, or 2 single-item questions assessment tools were included, studies were executed and presented in English from inception to March 7, 2025.11 papers were used into this meta-analysis.Results:1)In our meta-analysis,the multivariable-adjusted relative risk (RR) indicated that self-perceived stress was independently associated with stroke,OR=1.04(1.02,1.06).2)The subgroup analysis indicated that participants with elevated self-perceived stress exhibited a substantially increased risk of stroke, with an odds ratio of 1.31 (1.14, 1.50), whereas those with low self-perceived stress had no significant risk, with an odds ratio of 1.08 (0.99, 1.08).3)Moreover, our meta-analysis revealed that elevated self-perceived stress correlated with an increased risk of stroke mortality, exhibiting a modified risk ratio of 1.26 (1.07, 1.49);4)In sex-specific analysis,the multivariable-adjusted relative risk (RR) of stroke indicated that self-perceived stress correlated with stroke in women (1.07; 1.02-1.11), but not in men (1.03; 0.98-1.08).Self-perceived stress correlated with an elevated risk of stroke, particularly among individuals experiencing high levels of self-perceived stress and women.Additionally, self-perceived stress was correlated with stroke mortality.
Keywords: self-perceived stress, Stroke, Mortality, stress, Risk factors
Received: 19 May 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Li, Gao, Liu, Pei, Xu, Wang and Piao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lifeng Piao, piaolifeng2024@163.com
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