Stroke in former prisoners of war.

Objectives. Physiological changes associated with severe or chronic stress may place susceptible individuals at risk for diseases such as stroke. Methods. A cohort of World War II veterans consisting of former prisoners of war (POWs) and controls was studied. Data were from a follow-up examination in 1986 that included a standardized history, comprehensive examination, and psychiatric interview. Results. Of former POWs, 9.3% (44 of 475) reported strokes compared with 1.2% (1 of 81) for other World War II veterans. The relative risk for this association was 7.50 (95% confidence interval [CI], 1.05 to 53.7; chi(2) = 6.00, 1 df). There was no difference in the prevalence of hypertension or diabetes. Among the 475 former POWs, 12.7% (20 of 158) of those with posttraumatic stress disorder had strokes, compared with 7.6% (24 of 317) without posttraumatic stress disorder (relative risk, 1.67; 95% CI, 0.95 to 2.93; chi(2) = 3.25, 1 df). Conclusions. There appears to be an association between stroke and being a former POW. Our findings may begin to define a new class of stroke risk factors and extend our understanding of interactions between stress and disease.