Background: Emotional stress is a modifiable risk factor for stroke; however, the direct evidence linking the two remains insufficient. This study aims to elucidate the association of emotional stress and adaptive behavior with stroke risk.
Methods: The two-sample Mendelian randomization analysis utilized genome-wide association studies data from multiple sources, including the UK Biobank, the European Bioinformatics Institute, the Integrative Epidemiology Unit, and the FinnGen research project. Indirect effects were assessed using the "Product of coefficients" method.
Results: Low family relationship satisfaction is associated with increased risks of all stroke and all ischemic stroke. Mood swings elevate the risks of all stroke, all ischemic stroke, and large-artery stroke, while tension increases the likelihood of large-artery stroke and small vessel stroke. Surprisingly, nervousness appears to reduce the risk of intracerebral hemorrhage. Participation in group leisure activities may reduce the risks of all stroke, all ischemic stroke, and small vessel stroke. Adaptive behaviors that increase stroke risk include vigorous physical activity (all stroke), summer outdoor activities (all stroke and all ischemic stroke), winter outdoor activities (all stroke), and excessive TV watching (all stroke, all ischemic stroke, and large-artery stroke). Hypertension, Type 2 diabetes, atherosclerotic heart disease, and chronic ischemic heart disease mediate the relationship between emotional stresses, adaptive behaviors, and stroke subtypes.
Conclusions: The study suggests a genetic predisposition linking emotional stress and adaptive behavior to stroke subtypes. Individuals can easily modify adaptive behaviors and manage emotional stress in their daily routines. Understanding these connections has significant implications for stroke prevention.