A new study published in the journal BMC Medicine has linked prolonged stress with stroke.

Researchers in Sweden surveyed 600 recent stroke victims on their perceptions of their stress levels prior to being admitted to the hospital. The patients were asked to choose between six different alternatives to indicate how stressed they had felt before their stroke, from “never been stressed” to “constantly stressed over the past five years”. Their responses were compared with a healthy control group who were asked the same question.

The study suggests there is a link to stress in cases where the stroke is caused by atherosclerosis or to blood clots that have developed locally in the smaller vessels of the brain. The link was also found for patients in whom it had not been possible to establish the cause of the stroke despite an extensive evaluation.

“We do not know why stress appears to play a greater role in particular types of stroke, but it is an important finding as it prompts further studies on what role stress plays in the development of stroke,” said researcher Katarina Jood.

Health resources for managing stress include identifying its cause, getting plenty of exercise and eating a healthy diet. Relaxation techniques like breathing exercises, yoga, meditation and aromatherapy have also been suggested by healthcare practitioners.

Stroke is the third leading cause of death in the U.S. and is a leading cause of serious long-term disability, according to the Centers for Disease Control and Prevention.