Many strokes occur shortly after patients experience physical exertion or get upset

GALWAY, Ireland — An astounding one in 11 strokes occur within one hour of feeling upset or angry, according to a new global review of stroke survivors. Additionally, researchers from the National University of Ireland, Galway report one in 20 patients had engaged in a form of intense physical exertion shortly before suffering a stroke.

These findings are part of the larger INTERSTROKE study, which encompasses 13,462 cases of acute stroke across 32 different nations. Strokes are a leading cause of both death and disability all over the world. While most prior studies have focused on long-term stroke risk factors like obesity or a sedentary lifestyle, this project chose to investigate acute factors that may predict or even trigger a stroke just before it occurs.

Stroke prevention is a priority for physicians, and despite advances it remains difficult to predict when a stroke will occur. 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,” says co-lead researcher Professor Andrew Smyth, Professor of Clinical Epidemiology at NUI Galway and the director of the HRB-Clinical Research Facility Galway, in a university release.

Stroke risk spikes for an hour after getting angry

Researchers mostly focused on patients who had suffered an ischemic stroke, considered the most common type of stroke. An ischemic stroke occurs when a blood clot blocks or narrows arteries leading to the brain. The team also analyzed stroke patients of the intracerebral hemorrhage variety, which is less common but still quite serious and features brain tissue bleeding.

“We looked a two separate triggers. 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,” Prof. Smyth adds. “We also found that heavy physical exertion was linked to an approximately 60% increase in risk is of intracerebral hemorrhage during the one hour after the episode of heavy exertion. 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,” he continues.

“Our message is for people to practice mental and physical wellness at all ages. But it is also important for some people to avoid heavy physical exertion, particularly if they are high-risk of cardiovascular, while also adopting a healthy lifestyle of regular exercise,” concludes study co-author Dr. Michelle Canavan, Consultant Stroke Physician at Galway University Hospitals.

Regular exercise is not the same as an exerting task

Study authors note that a brief episode of heavy physical exertion, such as carrying a heavy object up a flight of stairs, is different than regularly staying physically active.

In summation, this work speaks to just how much sway our emotions hold over physical health outcomes. Most people will experience frustration or anger from time to time, but research like this just goes to show how important and beneficial it is to prioritize calmness.

The study appears in the European Heart Journal.