How to Stop a Stroke From Striking
Feb. 26, 2001 -- What sets off a stroke? Some surprisingly
routine things, apparently. According to a preliminary study of stroke
triggers, such commonplace activities as drinking alcohol, lifting a large box,
and indulging in a vigorous romp in the hay have been tied to the onset of
small "ischemic" strokes -- the kind caused by a clot that blocks blood
flow in an artery to the brain.
Results from the Stroke Onset Pilot Study were presented at the
American Heart Association's 26th International Stroke Conference, held
recently in Fort Lauderdale, Fla. At the same meeting, another group of
researchers reported that high blood pressure -- known to be a huge risk factor
for stroke in people who have had a previous stroke -- remains largely
uncontrolled in those seriously at-risk patients.
While many studies have identified risk factors for stroke --
such as high blood pressure and high cholesterol -- "we don't have very
good information about what immediately precipitates the stroke itself, what
behaviors trigger it at that moment," says Murray Mittleman, MD,
lead investigator of the Stroke Onset Pilot Study and director of
cardiovascular epidemiology at Beth Israel Deaconess Medical Center in
"Understanding the patterns in these triggers will
hopefully tell researchers more about the underlying biological mechanisms that
lead to a stroke," Mittleman tells WebMD. "From this new information,
we can hopefully develop novel preventive measures."
For the study, Mittleman and his colleagues recruited 50
patients who had been hospitalized for ischemic strokes. One-third of the
participants were women, and the average age was just over 62 years.
Each person was interviewed within two or three days after
having their stroke, to pinpoint whether there were patterns in their habits in
the days, weeks, and months before their stroke. Specifically, they were asked
what medications they were taking, if they were drinking caffeinated beverages
or alcohol, or if they were smoking or taking illicit drugs, including
marijuana and cocaine.
Researchers also asked about times when people had meals
(especially unusually large meals), whether they had strained to go to the
bathroom, had sexual intercourse, exerted themselves physically (like lifting a
large object), or become angry, anxious, or depressed.
"We were especially looking at the period right before the
stroke, looking at the person's behaviors [to see] whether that activity was
unusual for that person," Mittleman tells WebMD.
They found that 24 hours before having a stroke, one-third of
the patients had engaged in various activities that may have triggered the
- 28% drank alcohol
- 10% lifted an object that weighed more than 50 pounds
- 8% overly exerted themselves by doing things like shoveling snow
- 6% smoked marijuana
- 4% strained while trying to use the bathroom
- 4% had an angry outburst
- 2% had sexual intercourse