The findings of a new INTERSTROKE study have made headlines in a leading newspaper in Ireland and elsewhere – warning of anger, emotional upset, and heavy physical exertion as potential triggers of stroke.

The publication in European Heart Journal reported that using 13 462 cases of acute stroke in 32 countries, the researchers 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.

The INTERSTROKE investigators, including PHRI Senior Scientist Salim Yusuf, found that acute anger or emotional upset was associated with the onset of all stroke, ischaemic stroke, and intracerebral haemorrhage (ICH), while acute heavy physical exertion was associated with ICH only.

Martin O’Donnell

“Our message is for people to practice mental and physical wellness at all ages,” notes Michelle Canavan, a consultant stroke physician in Ireland and a co-author on the paper. ““It is also important for some people to avoid heavy physical exertion, particularly if they are high-risk of cardiovascular disease.”

PHRI Senior International Fellow Martin O’Donnell, of NUI Galway University in Ireland and co-lead on the study, added “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.”

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