Psychological stress significantly increases the risk of stroke in young women without known predisposing factors

Studies have shown that strokes in individuals under 50 have become more common, partly for unknown reasons. Up to 50% of young stroke patients do not have a specific cause for stroke, making these cases so-called cryptogenic strokes. 

The SECRETO study included 426 individuals under 50 who had recently experienced a cryptogenic stroke and 426 age-matched control subjects. Participants were recruited from 19 hospitals across Europe. The study collected extensive data on participants' previous medical conditions, lifestyles, and family backgrounds. 

Continuous stress as a risk factor for stroke in young women

The SECRETO study is the largest international study to demonstrate that increased psychological stress, especially when it persists at least at a moderate level, significantly increases the risk of stroke, particularly in young women (aged 18-49) whose stroke cause remains otherwise unknown. 

Stress was measured using an internationally accredited questionnaire. Patients were asked to assess their stress levels in various aspects of their lives during the month before their stroke. The same questionnaire was administered to the control subjects. 

Psychological stress is a modifiable risk factor through lifestyle changes. 

"The difference between young women and men may possibly be explained by the fact that young women have to balance different aspects of life more than men, which increases stress levels," says the first author of the article, doctoral researcher Shakar Kutal. 

A stroke at a young age can affect the patient's ability to study and work, family life, and functionality for decades. Therefore, it is essential to further investigate the mechanisms between stress and stroke risk, the researchers emphasize. Measures aimed at preventing strokes and advancing research are crucial for society. 

The study results have been published in the journal Neurology. The study is part of the international SECRETO multicenter study (Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome), led by HUS Neurology, which investigates the causes and background factors of cryptogenic strokes in young people. 

The research article:  Association between self-perceived stress and cryptogenic ischemic stroke in young adults: a case-control study.  The study was published online in the journal Neurology on March 5, 2025. 

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