Is it possible that happy occasions such as birthdays have negative effects on some people? I recall a 74-year-old woman, in apparent good health, who dreaded her upcoming 75th birthday. As the day approached, she became more and more anxious. She kept her fears to herself because they did not make sense. The “happy day” arrived and was celebrated as planned. Only some 7 months after the event was she willing to confide her worries to her doctor. She had vague complaints like a headache, dizzy spells, and fatigue but three different doctors found nothing more unusual than a rapid heartbeat. What caused her 75th birthday anxiety? She finally admitted that her mother had died at age 75 and she was convinced that she too was doomed to die at this age.
Such birthday-related stress may actually have a scientific basis. In this issue of Neurology, Dr. Gustavo Saposnik and coworkers1 report that vascular events (like strokes and heart attacks) are more common on birthdays. They suggest that the reason may be stress actually caused by the birthday.
How was the study done?
The researchers counted all visits to a hospital emergency room (ER) in their region to determine the expected number of vascular events that occur on a daily basis. Vascular events included major strokes, transient ischemic attacks (TIAs or mini strokes that last less than a day), and acute heart attacks. This expected number was compared with a control group, which included an expected number of nonvascular conditions. Asthma, appendicitis, and head trauma were chosen as the control conditions because people tend to go to the ER with these problems as quickly as they would for the vascular events.
What did the study find?
The chance of having a stroke, TIA, or heart attack on a birthday was 27% higher than the expected daily average. However, …
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