What Can Trigger a Stroke

While a great deal of attention is given to health and lifestyle factors that can contribute to stroke risk, a recent study indicates that emotional upset and exertion can also bring on a stroke.

A global study, INTERSTROKE, analyzed 13,462 cases of acute stroke in patients from 32 countries and a range of ethnicities. The study found that both physical exertion and emotional upset or anger are triggers that increase the risk of stroke in the short term. The study was published in the European Heart Journal, December 1, 2021, under the title “Triggers of stroke: anger, emotional upset, and heavy physical exertion. New insights from the INTERSTROKE study.”

In this study, stroke survivors were asked (sometimes with the help of family) if they had experienced anger or emotional upset or had engaged in heavy physical exertion within an hour of the stroke. As a control, they were also asked if they had experienced those conditions the day before at the same time of day. Since the patients self-evaluated “upset” or “angry” or “exertion,” they provided their own perspective on what they considered emotionally upsetting or heavy exercise, since they are subjective to individuals.

Emotional triggers

Anger and emotional upset were reported by 9.2% of participants. This accounts for about 1 in 11 stroke victims. Patients more likely to report anger or emotional upset included those who were male, were younger, had higher BMI, were more educated, and had higher levels of baseline stress and depression. Surprisingly, the odds of a stroke following an emotional trigger were actually higher in patients without prior depression and with lower education status.

Strokes from emotional triggers were associated with both hemorrhagic and ischaemic strokes. Research found that emotional anger or upset was associated with a 30% increase in risk of stroke within an hour of the incident.

Physical exertion trigger

Heavy exertion was reported by 5.3% of participants. This accounts for about 1 in 20 stroke victims. Patients more likely to report exertion were younger, more often male, and current smokers. They also had higher baseline activity levels and were not diabetic. Nonetheless, the odds of suffering a stroke after heavy exertion were actually greatest among women and lowest in patients with normal BMI.

Heavy exertion was associated with a 60% increase in the risk of hemorrhagic stroke within an hour of the event.

The study did not find increased risk from both triggers, emotional upset or anger and physical exertion, within the hour before the stroke.

Hospitalization and Surgery

When an individual is already in the hospital they have a greater risk for stroke. In fact, research by Ethan Cubler shows between 2 and 17% of stroke victims have symptom on-set during hospitalization. This is due, in part, to the correlation between stroke and some medical procedures and conditions that require intense medical treatment including heart disease. Even with highly skilled medical professionals, these strokes go undetected because the patient is lying down masking symptoms such as non-symmetrical arm movement. Neuralert will be part of the solution to ensure that these symptoms are detected and stroke intervention procedures can begin.

Decreasing stroke risk

While more research needs to be done to determine the mechanisms by which emotion and exertion bring on a stroke, this is valuable new information that should be considered by practitioners when developing a stroke-risk-reduction protocol, as well as post-stroke protocols to avoid repeat strokes.

Neuralert is part of the solution to help provide optimum medical care and decrease the risk of a debilitating stroke. Our non-invasive wrist-band technology combined with our patented AI algorithm can recognize true arm asymmetry, a hallmark symptom of stroke, while eliminating false positives.

More and more doctors and hospitals are partnering with Neuralert to provide their patients with this 24/7 stroke monitoring system in order to deliver an early warning, which could allow medical professionals to offer fast action, potentially decreasing the long-term effects of stroke. Contact us today to learn more about how Neuralert can partner with you.