Someone’s pushed your buttons, and you’re now red-faced, on the verge of tears or blowing your top.

It seems unhelpful, even provocative when you’re told: “Steady on, you’re going to pop an artery”.

But there’s some truth to it.

According to a new global review of stroke survivors, one in 11 survivors of stroke “experienced a period of anger or upset in the one hour leading up to it”.

Given that one in eight strokes is fatal within 30 days after the event, the incidence of emotional stress could be higher.

The study also found that one in 20 patients had engaged in heavy physical exertion.

The authors emphasise “that a brief episode of heavy physical exertion is different to getting regular physical activity, which reduces the long-term risk of stroke”.

The study

Many stroke studies have focused on medium to long-term risks, such as hypertension, obesity or smoking.

The new study investigated acute risks “that may act as triggers”.

The research analysed patterns in patients who suffered ischemic stroke – the most common type of stroke, which occurs when a blood clot blocks or narrows an artery leading to the brain.

They also investigated intracerebral haemorrhage, which is less common and involves bleeding within the brain tissue itself.

Cocktail of conditions leading to CVD event. Image: European Heart Journal

Professor Andrew Smyth, Professor of Clinical Epidemiology at NUI Galway and co-author of the study, said in a university release: “Our research found that anger or emotional upset was linked to an approximately 30 per cent increase in risk of stroke during one hour after an episode.”

He said there was 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,” Professor Smyth said.

Bigger risk for women

The researchers found that heavy physical exertion was linked to an about 60 per cent increase in risk of intracerebral haemorrhage.

He said 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 said.

The research was part of the global INTERSTROKE study – the largest research project of its kind, which analysed 13,462 cases of acute stroke, involving patients with a range of ethnic backgrounds in 32 countries, including Australia.

According to the Stroke Foundation, an estimated 27,428 Australians experienced stroke for the first time in their lives in 2020, and there were an estimated 445,087 survivors of stroke living in the community.