The consumption of cola drinks, vigorous exercise, sexual activity, drug use and the presence of fever or flu syndrome can be precipitating factors of a stroke in just a few hours in young adults.
This is reflected in an interesting and novel study carried out on people who suffered a first cerebrovascular accident and in which an attempt was made to see what their exposure to possible triggering factors had been in the hour or hours prior to the start of the strokes. stroke symptoms.
Researchers have found that the risk of developing a cerebrovascular accident multiplied by 2 in the hour after consuming a cola drink, by 2.4 in the two hours after having had sexual activity, by 2.4 in the hour following intense physical exercise, by 2.8 in the four hours after having consumed drugs and by 14.1 the day after having suffered from the flu or flu syndrome.
The ‘mystery’ of stroke in young people
An important feature of the study, published in the prestigious journal Neurology, is that it has been carried out in young adults, a sector of the population in which the incidence of stroke has increased in recent years. In addition, “in this age group, the percentage of stroke cases that remain with an unknown origin at the end of an exhaustive study is much higher than in older ages, so knowing possible triggers can be very useful,” he points out. Lorraine Benaventeneurologist at the Stroke Unit of the Central University Hospital of Asturias (HUCA).
The conclusions of this work are considered very interesting by neurology specialists, since they provide new knowledge that, at the same time, is in tune with some issues that were already known about the pathophysiology of stroke and that recent research is confirming, as explained by Sergio Callejaneurologist responsible for the stroke unit of the Central University Hospital of Asturias (HUCA).
“The study has caught our attention because it opens a spigot, a new way of approaching stroke in the young population”, adds Dr. Benavente.
Two types of stroke
Stroke is the manifestation of vascular disease in the brain, produced when an artery becomes clogged or ruptures, giving rise to the two main possible groups of strokes:
- The ischemic type: when what occurs is an obstruction of the artery that leaves an area of the brain without blood and, therefore, without functioning.
- The hemorrhagic type: in which the artery tears and floods an area of the brain with blood, which is also left in consequence and in a sudden way without functioning.
The test to determine whether it is an ischemic or hemorrhagic stroke will be a brain CT scan, indicates Sergio Calleja.
Risk factor’s
Age is one of the determining risk factors for the appearance of a stroke. Nevertheless, Experts consider the increase that has occurred in cases of stroke over the last two decades in young adults, from 40 years of age, to be striking. with studies that reflect an increase in cases between 20% and 25%, according to Dr. Calleja.
In addition to age, the classic risk factors for stroke are:
- Hypertension
- Diabetes
- hypercholesterolemia
- Obesity
- Toxic habits, such as tobacco and alcohol use, and other drugs
Traditional risk factors act over time and favor the appearance of arterial disease with their action, which can develop silently for years and ultimately lead to a stroke.
“What we know is that in people who develop arterial disease, their arteries begin to show fatty streaks, with deposits of cholesterol and inflammatory cells, which are the foundations on which, if the risk factors persist, it forms. the atherosclerotic plaque that, at a given moment, can generate a thrombus that clogs the arteries”, points out Dr. Calleja.
Precipitating factors acting within hours
The study now published does not focus on long-term risk factors, but on those that can act to trigger a stroke suddenly in a matter of hours, an approach that both Dr. Calleja and Dr. Benavente consider highly relevant.
Researchers have identified several precipitating factors with the ability to generate consequences in an hour or a few hours, leading to a stroke soon after. time to have actedthat is, “acting immediately, not prolonged over time”, indicates Sergio Calleja.
The research does not establish a causal relationship, but it does see a statistically significant link between certain situations and the appearance of the brain event, both specialists point out.
And although the conclusions of the study are novel, the experts point out that they link with already well-established knowledge about the pathophysiology of stroke.
Streak of arrhythmias after significant alcohol intake
Thus, it is already known that Significant alcohol intake can lead to a series of arrhythmias in the hour or two after consumption, which can act as a precipitating factor for stroke from the formation of a thrombus.
Intense exercise and arterial dysregulation
The recent study has also found in the cohort of patients analyzed a link between abundant alcohol intake or drug use and the appearance of a stroke, as well as between the practice of strenuous physical exercise and the manifestation of a hemorrhagic stroke, which is explain why All these situations generate arterial dysregulation, specifically, an episode of hypertension that can cause an artery to rupture.
Increased tension after sexual activity
This action is what can also explain the increased risk of stroke in the two hours following maintenance of a sexual activitywhen a punctual increase in blood pressure can occur, “which causes the rupture of the artery or alterations in the wall that can form a thrombus”, explains Lorena Benavente.
Drug use and inflammatory phenomena
As for drugs, “we already had indications that the consumption of substances, such as marijuana and, above all, cocaine, was related to inflammatory phenomena or vasculitis in the walls of the arteries, which It can be related to the appearance of not only hemorrhagic strokes but also ischemic ones”, Sergio Calleja points out.
Fever or flu syndrome, more powerful factor
And the most powerful precipitating factor found in the study is fever or the presence of a flu syndrome, which multiplies the appearance of a stroke by 14. The reason may be that the atherosclerotic plaque that could have remained inert for years becomes unstable due to inflammatory phenomena and clots can form on it, causing arterial obstruction.
This indication is in line with the appearance of more cases of stroke in people who have suffered from Covid-19, given that this disease gives rise to intense inflammatory phenomena that are related to the appearance of thrombi, “Covid-19 also acting as a precipitating factor.”
Cola drinks and hypertensive phenomena
As far as cola drinks are concerned, usually with a high load of sugar and caffeine, their consumption is related to hypertensive phenomena that can also explain the increased risk of stroke in the hour after consumption.
Both Calleja and Benavente highlight the relevance of the study having been published in a highly prestigious journal such as that of the American Neurology Association, as well as the value of the methodology followed and the fact that it has been developed on a relatively large cohort. large number of patients, specifically, 1,146 people, all of them young adults, between 18 and 49 years old, and who had suffered 1,043 of them an ischemic stroke and 103 a hemorrhagic stroke.
The research presents some limitations, recognized by its own authors, such as, for example, the limited number of cases in some subgroups of patients, that did not allow obtaining detailed data regarding the type of drugs consumed, for example.
All the participants in the research were given a questionnaire to measure the weight of certain factors that could have acted as precipitants and on which statistically significant evidence was found in the hour or hours prior to the onset of symptoms were the consumption referrals of cola drinks, sexual activity, intense sports practice, drug use and suffering from fever or flu syndrome.