[Coping with stress and blood viscosity in stroke prevention patients]. / Stressverarbeitung und Blutviskosität bei Schlaganfallvorsorgepatienten.

INTRODUCTION: Hematocrit, fibrinogen and blood viscosity influence blood fluidity and are well known stroke risk factors. Studies have shown relationships between these factors and psychological stress. AIM: The aim of this study was to investigate how stroke risk patients with increased hematocrit, increased fibrinogen, or increased plasma viscosity differ from patients free of these risk factors in their ways of stress coping. METHOD: 6503 persons participated in the following stroke risk investigations: biographical and risk factor orientated anamnesis, neurological status investigation, laboratory investigation, sonographic investigation and psychological investigation. After assessment of several risk factors, differences in stress coping between risk factor and non-risk factor groups were investigated by means of the t-test and the Wilcoxon-test. RESULTS: Men with pathological hematocrit showed significantly higher scores in the coping strategy resignation and a tendency to less positive self instruction and response control attempts. Women with higher values of hematocrit demonstrated higher values in resignation and drug intake. Men with higher fibrinogen showed significantly higher scores in distraction, vicarious satisfaction, minimising by comparison and tendency to flee as well as a tendency towards drug intake. Women with increased fibrinogen showed no differences. Men with normal plasma viscosity had significantly higher values in tendency to flee and tendencially in desire for social support and lower values in minimising by comparison. Women with increased plasma viscosity demonstrated higher scores in resignation and aggression. CONCLUSIONS: The presence of elevated values in parameters of blood viscosity coincides with increased passive and defensive coping mechanisms, whereas non-risk factor persons show raised values in active coping styles.

[Stress management in heart diseases, obesity, nicotine and alcohol use]. / Stressverarbeitung bei Herzkrankheiten, Ubergewicht, Nikotin- und Alkoholkonsum.

INTRODUCTION: Heart diseases, obesity, nicotine and alcohol abuse are all relevant stroke risk factors. Some studies refer to stress stimuli and coping strategies as modulators for stroke risk factors. AIM: This study investigated differences between stroke prevention patients with heart complaints, obesity, nicotine or alcohol abuse and stroke prevention patients without these risk factors. METHOD: 5993 stroke prevention patients participated in a medical-psychological stroke risk investigation at the Christian Doppler Clinic in Salzburg. The differences in coping strategies between groups of patients with risk factors and groups without were investigated by means of multivariate analysis of covariance. RESULTS: Significant differences in stress coping were found for every risk factor (split by sex). Men suffering from heart diseases showed higher values in the coping strategy tendency to flee. Women with heart complaints demonstrated significantly lower values in minimising by comparison. Obese/adipose patients performed significantly higher values in the coping strategies vicarious satisfaction and aggression (men). Nicotine abusing prevention patients showed significantly higher values in drug intake and lower scores in continued thoughts. Non-smoking men furthermore reached higher values in vicarious satisfaction and non-smoking women in minimising. Persons not consuming alcohol demonstrated higher drug intake and aggression (men). Wine drinkers showed lower scores of self-pity and increased situation control attempts (women). CONCLUSION: Prevention patients with risk factors demonstrated significant differences in coping strategies in comparison to those without risk factors. Persons with heart diseases demonstrate a more defensive behaviour. The risk factors obesity, nicotine and alcohol consumption are associated with a risk factor supporting stress coping behaviour. The modification of the coping strategies drug intake and vicarious satisfaction towards a more active confrontation could probably influence various risk factors (nicotine, alcohol consumption, obesity) simultaneously.

[Blood lipids and adaptation to stress as risk factors for stroke prevention]. / Blutfette und Stressbewältigung als Risikofaktoren in der Schlaganfallvorsorge.

Do stroke prevention patients with increased blood-fat-protein compounds (total cholesterol, HDL- and LDL cholesterol and triglyceride) have a different method of coping than patients with normal blood fat? 1159 stroke prevention patients participated in the following stroke risk investigations at this hospital: biographical and risk factor-orientated anamnesis, a neurological status investigation, a laboratory investigation, a sonographic investigation and a psychological investigation. The differences in the coping strategies of those patients with normal and those with higher blood-fat-protein compounds were investigated. Patients with higher total cholesterol showed significantly higher values in the avoidance of stress situations (sig. 0.041) and a stronger tendency towards escapist behaviour (sig. 0.05). Patients with normal HDL cholesterol values indicated a tendency (sig. 0.07) to higher values in positive self-instruction in comparison to patients with reduced HDL cholesterol values. Those prevention patients with higher LDL values showed a tendency (sig. 0.08) to higher values in the intake of narcotic substances (nicotine, alcohol, tranquillisers, pharmaceutical agents). Patients with increased triglyceride indicated significantly higher values in coping by compensation (eating, shopping, reward behaviour, watching TV; sig. 0.037) and the intake of narcotic substances (sig. 0.044). Prevention patients with higher total cholesterol, LDL/HDL, or triglyceride values showed significantly different coping strategies in comparison to those patients with normal values. Increased avoidance and escapism behaviour and also compensation and the abuse of narcotic substances could be seen in connection with an increase in the risk of a stroke. In contrast, a constructive coping strategy such as positive self-instruction could reduce the risk of a stroke, which goes along with normal HDL cholesterol.