Can Stress Cause a Stroke?

Feeling stressed is normal. And it can feel like there’s always more to be stressed about. Stress does serve a purpose and is a normal feeling. But when it lasts for a long time (chronic stress), it can cause more harm than good. It can even contribute to serious health complications, like high blood pressure, heart disease, and strokes. 

A stroke happens when part of the brain doesn’t get the blood and nutrients it needs. A stroke can cause different symptoms, depending on the part of the brain it affects. Typically, part of the face or body may feel weak. Sometimes, a stroke affects speech or vision. 

Stress alone won’t cause a stroke. But chronic stress can increase your risk of having a stroke. 

How can stress cause a stroke?

Stress increases the risk of stroke in a few different ways. Stress can increase or raise:

• Cholesterol levels in the blood

• Blood pressure

• Glucose levels in the blood

These changes lead to stiffening of the arteries, also known as atherosclerosis. The development of atherosclerosis in the arteries that supply the brain with blood presents a problem. Stiff arteries are more likely to narrow and get blocked. If that happens, blood can’t get to the brain cells. Without blood, brain cells die. This is what causes a stroke. 

In addition to atherosclerosis, people who are stressed are more likely to turn to unhealthy coping behaviors, like drug and alcohol use or smoking. These all increase the risk of a stroke too.

Stress-induced hypertension

Stress is supposed to raise blood pressure. It’s part of the fight-flight-freeze response. But when the stressor is gone, blood pressure should fall right back into the normal range. Sometimes, it doesn’t. This chronic high blood pressure can damage arteries. 

Experts think stress acts in a couple of different ways to cause hypertension. First, repeatedly being exposed to stressful situations causes blood pressure to go up and down. Over time, the repeated drastic changes in blood pressure can cause damage to the arteries, including those in the brain. 

Second, stress causes the nervous system to release large amounts of hormones that cause the arteries to tighten (vasoconstriction). This can cause your blood pressure to rise. As long as you’re experiencing stress, the body will continue to make these hormones.

Things like job strain, racism, and environmental stressors can raise blood pressure. And if you have more than one stressor, the effect on blood pressure is multiplied.

How high can blood pressure go before a stroke?

It’s not possible to predict exactly what blood pressure level will lead to a stroke. This is why keeping blood pressure at normal levels over time is the safest approach. Dangerously high blood pressure levels are when they reach 180/120 mm Hg or greater. This can put you at increased risk for stroke symptoms and can lead to a medical emergency.

But any blood pressure higher than the normal range can be dangerous too. Over time, sustained high blood pressure can lead to blocked arteries in the brain, causing a stroke. Some arteries are more likely to have blockages than others. At-risk arteries include ones that already have atherosclerosis. 

Stress increases other stroke risk factors

Along with blood pressure, stress can also increase other risk factors for stroke. It doesn’t feel good to be stressed all the time. When people don’t feel well, they can sometimes resort to other behaviors to feel better. Things that may seem comforting, but which make stress more harmful, include:

• Smoking 

• Excessive alcohol use

• Emotional eating 

• Activities that cause sleep deprivation (social media, TV, or computer use before bed)

These behaviors may feel like they help in the moment, but they are harmful to your health in the long run. 

What type of stroke is caused by stress?

There are two main types of strokes. The most common is called an ischemic stroke. Ischemic strokes happen when a blood vessel gets blocked. Blockages can happen over time due to atherosclerosis. Or they can happen all of a sudden due to blood clots that form in the brain or travel from a different location to the brain.

The other type of stroke is a hemorrhagic (bleeding) stroke, which happens when a blood vessel in the brain bursts. The main cause of hemorrhagic strokes is high blood pressure. Some of the main contributors to hypertension and hemorrhagic strokes are:

• Stress

• Being considered overweight

• Lack of exercise

• Smoking

• Excessive alcohol use

What are signs of a stress stroke?

The signs of a stroke depend on where the stroke happens in the brain. Some of the symptoms to watch out for include sudden onset of:

• Numbness or weakness in the face, arm, or legs

• Headache without a known cause

• Trouble seeing in one or both eyes

• Confusion or trouble speaking

• Trouble walking, loss of balance, or dizziness 

What does the research say about stress and stroke risk?

Science shows that stress is linked to increased stroke risk in the following ways: 

• The faster your blood pressure shoots up after a stressor, the more likely you are to have a stroke. 

• Men with stressful jobs are twice as likely to have a stroke. 

• Men with chronic stress have double the risk of stroke over the next 20 years.

There does not appear to be the same increased stroke risk due to stress for women. More research is needed to determine the links between stress and stroke risk in people who are transgender and gender diverse. 

How to reduce stress and avoid a stroke

Learning techniques to cope with stress can improve health and make life more enjoyable. And reducing stress may help reduce your risk of stroke. Some ways to reduce stress include:

• Get some exercise (yoga, walking)

• Develop a support network

• Limit alcohol, food, and smoking as a way to deal with stress

• Go outside

• Practice mindfulness, express gratitude, and learn deep-breathing techniques

• Get plenty of sleep

• Eat a nourishing, balanced diet

• Be aware of your triggers

• Limit time on digital devices

Many of these habits not only reduce stress but can also help improve blood pressure as well.

Why trust our experts?

Written by:

Meg Burke, MD

Meg Burke, MD, is a practicing primary care geriatrician in the Denver, Colorado area. She is board-certified in internal medicine and geriatric medicine, and received her undergraduate and medical degrees from Georgetown University in Washington, D.C. After graduating from medical school, Dr. Burke completed her internal medicine residency at Johns Hopkins Bayview Medical Center and her two years of subspecialty training in geriatric medicine at the Johns Hopkins Hospital in Baltimore, Maryland.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

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