An upbeat attitude might help prevent a second stroke
If you've had a stroke, a positive outlook might just help prevent another one, a new study suggests.
Researchers found that when people felt they could protect themselves from a second stroke, they had lower blood pressure. High blood pressure is a significant risk factor for a recurrent stroke.
"You can protect yourself against stroke by reducing your risk factors. And this study shows that if you think you can do it, you can," said the study's senior author, Bernadette Boden-Albala. She's a professor of epidemiology at NYU College of Global Public Health in New York City.
The connection between the mind and the body is of growing interest in medicine. But can people actually think themselves well?
The study seems to suggest it's possible.
The researchers looked at data on more than 400 people who survived a mild or moderate stroke or had had a transient ischaemic attack (also known as a TIA or mini-stroke). The group was half female. Their average age was 64.
Thirty percent of the group was white, about one-third were black and another one-third were Hispanic.
The study volunteers were asked to agree or disagree with statements, such as: "I worry about having a stroke"; "I can protect myself against having a stroke"; and "Some people are more likely to have a stroke than others."
Systolic pressure more significant
Almost 80% agreed with the statement that they could protect themselves. When compared to a group of people who disagreed, those who thought they could protect themselves reduced their systolic blood pressure by about 6mm Hg more than the negative-thinking group a year post-stroke. Systolic blood pressure is the top number in a reading.
Boden-Albala said the researchers didn't include diastolic (the bottom number) blood pressure readings in the analysis, because systolic pressure is the one that appears related to stroke risk. The higher your systolic pressure, the greater the risk of stroke, she said.
How might a positive outlook affect your blood pressure?
"It may be that self-efficacy [feeling as if you can protect yourself] is a proxy for readiness to change," Boden-Albala said. So it may be that people who had a brighter outlook were able to cut back on salt, eat more fruits and vegetables, or exercise more, she suggested.
While everyone in the study was given some information on preventing another stroke, those with positive thinking may have had the "confidence to take control over their lives", she added.
Boden-Albala said stress may play a role as well. And those who felt they had control would likely feel less stressed.
Importance of holistic treatment
"The worst thing you can do is tell someone that they can't do anything about a situation. People need skills and resources to do something, or they'll be stressed," Boden-Albala explained.
Dr Deepan Singh is a psychiatrist at NYU Winthrop Hospital in Mineola, New York.
He said, "Patients with a positive attitude had lower systolic blood pressure, irrespective of gender, race etc., and regardless of intervention status. People with a sense of control seemed destined to have a better outcome."
But that doesn't mean positive thinking should replace standard treatment strategies. It does, however, suggest the importance of treating patients holistically, said Singh, who wasn't involved in the study.
Singh said the take-home message from this study is really for care providers: "Be proactive with educating patients and be aware that maintaining a positive outlook can have a positive outcome."
Both experts said it would be a good idea for doctors to pay attention to their patients' attitudes. Someone expressing a lot of negativity may need to be directed to additional resources to learn how to reduce their risk of another stroke, and perhaps referred for more help.
The study results were scheduled for presentation at an American Stroke Association meeting in Honolulu. Findings presented at meetings should be viewed as preliminary until they're published in a peer-reviewed journal.
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