Jan 21, 2026
3 min read
A primary care study links depression to an increased risk of hemorrhagic stroke
Luis Ayerbe, attending family Kituo chase up to the Cajalh huckon and the Cajalh hucka Affair
Fatigue and insomnia are not the only symptoms associated with this disease.
Depression: According to a Spanish study conducted by primary care researchers, this disorder can increase the risk of suffering from the disease.
Hemorrhagic stroke.This review is up to
28 percent of patients with the mental health problem.
When evaluated
Susceptibility and mortality from stroke in psychiatric patients, the results of this systematic review emphasize "the high evidence of an increased risk of stroke in patients with depression".However, the relationship between this medical condition and other
The mental pathologies shown in the review are "limited", as explained by Luis Ayerbe, a family doctor at the Health Center of Ramón y Cajal (Alcorcón) and one of the main authors of this study.
Research Limitations
However, the doctor thinks that this work "must be put together with previous studies that show an increased risk of brain disease or stroke in patients with schizophrenia, bipolar disorder, depression, or anxiety."Then, in specific situations such as bipolar disorder or personality disorder, "it is not possible to say with certainty that people with these two problems do not have a high risk of hemorrhagic stroke", because the current evidence is "very limited", he explained, referring to the research conducted during the review of two studies of Mendelian randomization and other group studies.
In fact, in terms of methodology, although Mendelian randomization studies "are a very interesting tool in epidemiology", Ayerbe recognizes that they also have limitations, as the results obtained are not very intuitive and "do not correspond to the observations of real patients diagnosed with psychiatric problems", so they must be "interpreted with caution".It is possible that the limitations of these studies prevent the observation of existing associations", suggests the doctor.
Primary cardiovascular risk control
In addition, given the available evidence on the explanatory factors for the increased cardiovascular risk in patients with psychiatric disorders, the researchers consider the systematic lack of an association between depression, anxiety, schizophrenia and bipolar disorder with hemorrhagic stroke presented in two of the studies included in the review as “an unexpected finding.”
"Although the mechanisms that explain these results are unclear," Ayerbe and other primary care experts see a "greater cardiovascular risk in psychiatric patients," especially considering the group's role in preventing "cardiovascular problems" and even cancer.
Therefore, the approach used in the primary care consultation should be "comprehensive", which not only shows the need for antidepressants, but also the constant control of pressure and other cardiovascular risk factors, provided that it is not limited to just one session, explains the family doctor.
As the study suggests, it is likely that the observed associations "have a multifactorial mechanism" that is "related to the high prevalence of cardiovascular risk factors in these psychiatric patients, poor access to health care, and greater use of medications that increase the risk of cardiovascular events," as indicated by previous evidence.
And, although "hypothetical", the mechanisms that explain the relationship between mental health and stroke can be both medical, since a higher risk of blood vessels in the body has been described in people who use serotonin reuptake inhibitors (SSRIs), and biological (weakness of the body, work of oxidative stress, work of the body. Disease).
However, due to the lack of evidence to support this idea and the need to increase the number of studies, Ayerbe believes that it is still too early to accept the determination of any biological marker as a predictor of stroke, "except those that are already known, such as diabetes, hypertension, dyslipidemia, etc."
Given that the study was designed from primary care, where we covered a broad range of diagnostic categories, there are still opportunities in other specialties to find out whether "more specific types of psychiatric problems are associated with an increased risk of primary intracerebral hemorrhage (PICH) and subarachnoid hemorrhage (SA)."
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