July 28, 2006

ER visits for stroke increase around birthdays

By Charnicia Huggins

NEW YORK (Reuters Health) - Birthdays may be a more risky
time for some older folks, results of a new study suggest. The
findings show that visits to the emergency department for
stroke, heart attack, and other vascular events are more common
on birthdays than on other days, particularly among individuals
with high blood pressure.

The results suggest that birthdays may have a role in
triggering strokes, transient ischemic attacks (TIAs) and heart
attacks, study co-author, Dr. Gustavo Saposnik, of the
University of Toronto in Canada, told Reuters Health.

Transient ischemic attacks, sometimes referred to as
"mini-strokes," occur when the blood supply to the brain is
temporarily reduced. The symptoms are usually minor and
transient, although they signal an increased risk of a more
serious stroke.

It has been suggested that stressful life events, holidays
or other special days may trigger vascular events. To
investigate the possible association between birthdays and such
events, Saposnik and colleagues analyzed data reported by 188
ambulatory care facilities for individuals admitted to the
emergency department for strokes, TIAs or heart attacks from
April 2002 through March 2004.

More than 24,000 admissions to the emergency department
were due to stroke, over 16,000 were due to TIAs and 29,000
were for heart attacks. For each event, the corresponding
average patient age was 74.0, 72.5 and 68 years old.

In each case the vascular events occurred more frequently
on patients' birthdays than the expected daily number of such
events, the investigators report in this month's issue of

On a typical day, for example, emergency departments expect
to receive 67 visits due to stroke. Yet, Saposnik and
colleagues found that 87 cases of stroke occurred on patients'
birthdays. Similarly, 58 cases of TIA and 97 cases of heart
attack occurred on birthdays, in comparison to the expected 44
and 80 daily visits to the emergency department, respectively,
for these events.

The increase in vascular events on birthdays was greater
than the increases observed on other special days, including
Christmas and other holidays, the report indicates.

Overall, stroke, heart attacks or TIAs were 27 percent more
likely to occur on birthdays, compared with the expected daily
average. People with high blood pressure appeared to be at
greatest risk, Saposnik and his team note.

Although the researchers did not investigate the reasons
for the association, they suggest that "a birthday may
represent an acute psychosocial stressor for some individuals,
as it may induce several emotional, physical, and mental

An association between birthdays and other medical events,
such as asthma attacks, appendicitis or head trauma, was not

Based on the findings, Saposnik advises that people avoid
drinking excessive amounts of alcohol, watch their intake of
fatty foods, avoid strenuous physical activity, and stick to
their medication regimens, especially during the time
surrounding their birthday.

SOURCE: Neurology, July 2006.