|
Abrupt
Change
in
Body
Position
Can
Trigger
Stroke
-
Stress/Anger,
Too!
Feb.
10,
2002
-
Sudden
movements
as
simple
as
jumping
when
the
doorbell
rings
can
trigger
ischemic
stroke,
according
to
a
preliminary
study
presented
Friday
at
the
American
Stroke
Association's
27th
International
Stroke
Conference
in
San
Antonio.
"Abrupt
changes
in
body
position
caused
by
sudden
loud
noises,
calls
for
help
or
other
unexpected
events
occurred
within
two
hours
of
stroke
onset
in
more
than
one-fifth
of
the
stroke
patients
we
studied,"
says
Silvia
Koton,
M.Occ.H.,
R.N.,
of
the
department
of
epidemiology
and
preventive
medicine
at
Tel
Aviv
University.
Ischemic
strokes
are
the
most
common
type
of
stroke.
They
occur
when
a
blood
clot
blocks
blood
flow
in
an
artery
to
the
brain.
Researchers
assessed
the
potential
stroke-triggering
effects
of
emotional
stress,
anger,
sudden
physical
effort,
sudden
changes
in
environmental
temperature
and
sudden
changes
in
body
position.
By
comparing
activities
the
day
of
the
stroke
to
the
previous
day,
participants
acted
as
their
own
control
group,
making
this
a
prospective
case-crossover
study.
The
relative
risk
of
stroke
among
patients
exposed
to
at
least
one
trigger
during
a
two-hour
"hazard
period"
preceding
the
stroke
was
more
than
seven
times
higher
compared
to
similar
exposures
during
the
same
two-hour
period
the
day
before
the
stroke.
The
stimulus
with
the
highest
risk
was
a
sudden
change
in
body
position
or
posture.
Negative
emotional
stress/anger
was
second
highest.
Several
studies
have
examined
the
triggering
effect
of
selected
personal
and
environmental
factors
on
the
risk
of
heart
attacks.
It
has
been
shown,
for
example,
that
heavy
physical
exertion
can
trigger
a
heart
attack
within
less
than
an
hour,
probably
by
dislodging
fragments
of
plaque
from
the
arteries,
which
then
block
blood
supply
to
the
heart.
But
until
now
it
hasn't
been
clear
whether
similar
factors
act
as
triggers
for
ischemic
stroke.
"The
triggering
mechanism
for
ischemic
stroke
may
be
comparable,
in
part,
to
that
for
a
heart
attack,
but
the
mechanisms
underlying
ischemic
stroke
are
more
complex
than
those
underlying
heart
attack,"
says
Koton.
"Various
triggers
may
act
differently
and
we
are
studying
those
issues.
Even
if
the
hazard
period
for
stroke
turns
out
to
be
different
than
two
hours,
the
information
we're
collecting
will
still
allow
us
to
assess
the
influence
of
this
type
of
exposure
during
a
given
time
period."
Thus
far,
the
Israeli
researchers
have
examined
150
stroke
patients
-
39
percent
women,
average
age
68.
Those
with
dementia
or
aphasia
(difficulty
speaking
or
understanding
words)
were
excluded.
They
were
interviewed
one
to
four
days
after
having
a
stroke.
Sixty-seven
patients
(44.7
percent)
reported
experiencing
potential
triggering
events
during
the
two
hours
prior
to
onset
of
their
strokes.
Of
those,
33
patients
(22
percent)
reported
sudden
changes
in
body
position,
and
20
(13.3
percent)
reported
negative
emotional
stress.
Estimates
of
the
risk
associated
with
other
triggers
studied
will
require
a
larger
sample
size,
say
researchers.
"The
most
important
finding
of
this
study
is
the
recognition
of
new
risk
factors
for
ischemic
stroke
that
function
as
short-term
triggers
rather
than
factors
such
as
hypertension
and
smoking,
which
affect
long-term
risk,"
says
Koton.
"Older
people,
in
particular,
need
to
be
aware
of
the
potential
negative
influence
of
reactions
to
emotions
and
to
sudden
exposure
to
familiar,
but
startling
activities
such
as
a
ring
of
a
doorbell
or
telephone."
As
a
preventive
step,
the
public
should
be
informed
of
the
various
potential
triggers
for
stroke.
"Stress
and
anger-coping
programs
could
be
offered
to
high-risk
groups,"
she
says.
"The
possibility
of
prescribing
preventive
medications
to
specific
high-risk
groups
also
needs
to
be
investigated."
The
American
Stroke
Association
is
a
division
of
the
American
Heart
Association.
The
study
is
a
joint
project
of
Tel
Aviv
University's
Sackler
Faculty
of
Medicine,
the
Israel
Center
for
Disease
Control
and
the
Sourasky
and
Sheba
Medical
Centers
in
Tel
Aviv.
Other
researchers
taking
part
in
the
study
include
Natan
M.
Bornstein,
M.D.;
David
Tanne,
M.D.;
and
Manfred
S.
Green,
M.D.,
Ph.D.
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