2014 Articles

Stroke survivors’ endorsement of a “stress belief model” of stroke prevention predicts control of risk factors for recurrent stroke

Phillips, L. Alison; Tuhrim, Stanley; Kronish, Ian M.; Horowitz, Carol R.

Perceptions that stress causes and stress-reduction controls hypertension have been associated with poorer blood pressure (BP) control in hypertension populations. The current study investigated these “stress-model perceptions” in stroke survivors regarding prevention of recurrent stroke and the influence of these perceptions on patients’ stroke risk factor control. Stroke and transient ischemic attack survivors (N = 600) participated in an in-person interview in which they were asked about their beliefs regarding control of future stroke; BP and cholesterol were measured directly after the interview. Counter to expectations, patients who endorsed a “stress-model” but not a “medication-model” of stroke prevention were in better control of their stroke risk factors (BP and cholesterol) than those who endorsed a medication-model but not a stress-model of stroke prevention (OR for poor control = .54, Wald statistic = 6.07, p = .01). This result was not explained by between group differences in patients’ reported medication adherence. The results have implications for theory and practice, regarding the role of stress belief models and acute cardiac events, compared to chronic hypertension.