Anger, emotional upset associated with stroke
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Anger or emotional upset was associated with all stroke types, according to study findings published in European Heart Journal.
“Acute anger or emotional upset was associated with the onset of all stroke, ischemic stroke and intracerebral hemorrhage, while acute heavy physical exertion was associated with intracerebral hemorrhage only,” Andrew Smyth, MD, PhD, MSc, professor of clinical epidemiology at NUI Galway and director of the HRB at Clinical Research Facility Galway, Ireland, and colleagues wrote.
In a case-control study, the researchers observed cases of acute first stroke at 142 centers in 32 countries and “adopted a case-crossover approach to determine whether a trigger within 1 hour of symptom onset (case period), vs. the same time on the previous day (control period), was associated with acute stroke.”
Of the 13,462 cases (mean age, 62.2 years; 59.6% men), 9.2% were associated with anger or emotional upset. Episodes of anger or emotional upset were associated with increased odds of all stroke types (OR = 1.37; 99% CI, 1.15-1.64), ischemic stroke (OR = 1.22; 99% CI, 1-1.49) and intracerebral hemorrhage (OR = 2.05; 99% CI, 1.4-2.99).
The researchers found 5.3% of the cases were engaged in heavy physical exertion, but that was only associated with increased odds of intracerebral hemorrhage (OR = 1.62; 99% CI, 1.03-2.55).
“There was no modifying effect by region, prior cardiovascular disease, risk factors, cardiovascular medications, time or day of symptom onset,” the researchers wrote. “Compared with exposure to neither trigger during the control period, the odds of stroke associated with exposure to both triggers were not additive.”
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