Researcher Andrew Smyth points out that medical professionals are continuously trying to figure out how to better predict when strokes will occur and that his team’s work may be able to provide a helpful, new perspective.
“Many studies have focused on medium to long-term exposures, such as hypertension, obesity, or smoking. Our study aimed to look at acute exposures that may act as triggers,” Smyth said.
Knowing the risks
For the study, the researchers analyzed data from the INTERSTROKE study, which includes information on more than 13,000 cases of strokes from 32 countries. The team was most interested in revealing patterns among stroke patients to better understand some of the factors that trigger the condition. The study focused on patients who had ischemic strokes and intracerebral hemorrhages.
To understand if one of the risk factors led to a stroke, it had to occur within one hour of when the patient started experiencing stroke symptoms. The researchers compared that information with how the patient responded at the same time the day prior to the stroke.
The team identified episodes of anger or emotional upset and heavy physical exertion as two triggers that may incite a stroke. One in 11 patients experienced emotional disturbances prior to their stroke, and one in 20 had engaged in serious physical activity.
“We looked at two separate triggers,” Smyth said. “Our research found that anger or emotional upset was linked to an approximately 30% increase in risk of stroke during one hour after an episode – with a greater increase if the patient did not have a history of depression. The odds were also greater for those with a lower level of education.
“We also found that heavy physical exertion was linked to an approximately 60% increase in risk of intracerebral hemorrhage during the one-hour after the episode of heavy exertion,” he added. “There was a greater increase for women and less risk for those with a normal BMI. The study also concluded that there was no increase with exposure to both triggers of anger and heavy physical exertion.”
Following a healthy lifestyle
While knowing these triggers may help consumers lower their risk of having a stroke, the researchers emphasized that following a healthy lifestyle is critical for long-term health outcomes.
“Some of the best ways to prevent a stroke are to maintain a healthy lifestyle, treat high blood pressure, and not to smoke, but our research also shows other events such as an episode of anger or upset or a period of heavy physical exertion independently increase the short-term risk,” said researcher Martin O’Donnell. “We would emphasize that a brief episode of heavy physical exertion is different to getting regular physical activity, which reduces the long-term risk of stroke.”