engleski

Influence of prolonged stress on stroke appearance

A clinical experience of the increased rate of stroke incidence among the refugees and the displaced persons during and after the Croatian Defense War (1991-1995) initiated our investigation on the presence of risk factors and the cerebral hemodynamics in this population, trying to define the possible underlying mechanisms responsible for stroke. A group of 120 refugees aged 20 to 60 years, who have been living for more than 5 years in a refugee center in Eastern Croatia, with clinical symp-tomatology of chronic posttraumatic stress was investigated ; a control group of the same age and gender characteristics was compared. The epidemiologi-cal investigation included the eleven risk factors and the functional evaluation of cerebral circulation by the TCD (Transcranial Doppler Sonography). In a refugee group a significant increase was found in the following parameters: arterial hypertension, hyperlipydemia, smoking, adiposity, and physical inac-tivity (p < 0.05), while in the control group alcoholism was more frequent (p < 0.05). No significant differences were found in: diabetes, cardiac arrhythmias, gender, age, genetic factors. The TCD disclosed the functional abnormalities more frequently (p < 0.05) in a refugee group: vasospasms in younger subjects - probably due to sym-pathetic predominance mostly due to nicotinic effects, and arteriosclerotic stenoses with consequent hemodynamic changes in older subjects. The authors conclude that the chronic psychosocial stress due to the war sufferings, increases the risk of stroke appearance through the described neu-robiologic mechanisms. A prolonged psychological stress and the accompany-ing socioeconomic factors with a complete change of life-style of the refugees and the displaced persons lead to arterial hypertension and hyperlipydemia, induce noxious habits like smoking and restrictions in physical activities, as- sisting in that way in the progress of arteriosclerosis, and directly or indirectly influence the cerebral hemodynamics, enhancing the risk of stroke. There is an obvious necessity to apply the adequate preventive medical and psychosocial measures in such situations.

prolonged stress ; stroke ; Croatian defense war

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