Key result
A strong sense of coherence was associated with a reduced rate of incident stroke compared to a weak sense of coherence (RR 0.76; 95% CI 0.60-0.96).
Why the study?
Does a strong sense of coherence (SOC) and faster adaptation to social adversity reduce incident stroke in adults aged 41 to 80 without prior stroke?
Cohort (n=20,629)
No
Does a strong sense of coherence (SOC) and faster adaptation to social adversity reduce incident stroke in adults aged 41 to 80 without prior stroke?
Effect estimate: RR 0.76 (95% CI 0.60-0.96)
A strong sense of coherence and faster adaptation to social adversity are associated with a significantly reduced risk of incident stroke.
Strong SOC may identify lower-risk adults; leaves open whether targeting coherence reduces stroke incidence.
BACKGROUND AND PURPOSE: Laboratory-based studies have suggested that individual differences in cardiovascular reactivity and stress adaptive capacity are associated with stroke incidence. We test the hypothesis that sense of coherence (SOC), a marker of social stress adaptive capacity, is associated with incident stroke in a population-based prospective cohort study. METHODS: A total of 20,629 participants, aged 41 to 80 years, in the UK European Prospective Investigation into Cancer (EPIC)-Norfolk study, who had not previously experienced a stroke, completed assessments that included SOC and details of their experience of life events during adulthood. An index of adaptation was constructed from responses to questions concerning over 80,000 adverse life events. RESULTS: During 145,000 person-years of follow-up (mean 7.1 years), 452 participants experienced either a fatal or nonfatal stroke event. A strong (as opposed to a weak) SOC was associated with a reduced rate of stroke incidence (rate ratio 0.76; 95% CI, 0.60 to 0.96) after adjustment for age, sex, pre-existing myocardial infarction, diabetes, hypertension treatment, family history of stroke, cigarette smoking, systolic blood pressure, obesity, social class, education, hostility and depression. No sex difference in this association was observed. Measures of social adversity occurrence and impact were not associated with stroke incidence, whereas faster reported adaptation to adverse event exposure was associated with a reduced rate of stroke incidence (rate ratio 0.89; 95% CI, 0.81 to 0.98; per standard deviation change in adaptation score, adjusted for age and sex). CONCLUSIONS: Stress adaptive capacity is a potentially important candidate risk factor for stroke.
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Surtees et al. (2007) conducted a cohort in Stroke (n=20,629). Strong sense of coherence (SOC) vs. Weak sense of coherence was evaluated on Fatal or nonfatal stroke event (RR 0.76, 95% CI 0.60-0.96). A strong sense of coherence was associated with a reduced rate of incident stroke compared to a weak sense of coherence (RR 0.76; 95% CI 0.60-0.96).
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