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(Stroke. 2007;38:e35.)
© 2007 American Heart Association, Inc.

Letters to the Editor

Response to Letter by Vale

Department of Neurology, Boston University School of Medicine, Boston, Mass

Response:

We thank Dr Vale for his comments on our study. He raises an interesting question as to whether deregulated stress response could be an underlying mechanism for the association between depressive symptoms and risk of stroke. As we stated in our article, the biological pathways by which depressive symptoms are associated with stroke risk remain unclear. Do psychological factors act to augment stroke risk or are they the result of a subclinical cerebrovascular process evident on brain MRI¹? Dr Vale has suggested a plausible mechanism not considered in our discussion: namely, that there is a subgroup of depressed individuals who react to mental stress with intense immune activation thus making them more prone to atherosclerosis. He proposes that it may be worthwhile to measure salivary -amylase, which has been shown to be elevated at times of psychological stress in healthy adults. However, increased levels of salivary -amylase have not been demonstrated prospectively to be associated with increased incidence of stroke or other cardiovascular disease. We thank Dr Vale for bringing this novel hypothesis to our attention.

Acknowledgments

Disclosures

None.

References

1. Steffens DC, Krishnan RR, Crump C, Burke GL. Cerebrovascular disease and evolution of depressive symptoms in the cardiovascular health study. Stroke. 2002; 33: 1636–1644.[Abstract/Free Full Text]

This Article Extract Full Text (PDF) All Versions of this Article: 38/6/e35    most recent STROKEAHA.107.482885v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kelly-Hayes, M. Articles by Wolf, P. A. Search for Related Content PubMed Articles by Kelly-Hayes, M. Articles by Wolf, P. A.