Posts Tagged "Stroke"

Baby 1Researchers found that women who had given birth might have a reduced risk of death from several common conditions than those who had not, according to a study released Friday by the Imperial College London (ICL).

The study, led by ICL researchers, was published in the journal BMC Medicine. It investigates the association between the so-called reproductive factors – such as having children and breastfeeding – and a woman’s risk of death.

Researchers analyzed data from 322,972 women across 10 countries, including the UK, France, Germany and Sweden, with an average age of 50.

Each woman was followed for an average of 12.9 years. During this period, there were 14,383 deaths overall, which included 5,938 deaths from cancer and 2,404 deaths from circulatory system diseases,baby 2 according to the study.

The team compared a host of reproductive factors with risk of death from several common conditions, such as breast cancer, stroke and heart disease.

The researchers found that women who had given birth had a 20 per cent reduced risk of death than those who had not. It was also found that there was a reduced risk of death (eight per cent) in women who had breastfed compared to those who did not.

The risk of death from cancer was lower in those that had given birth compared to those that had not. Within this group, the risk was reduced even further in women that gave birth to two or three children in comparison to those who had one child.

Source: English News

More intensive management of high blood pressure, below a commonly recommended bloodblood pressure 2 pressure target, significantly reduces rates of cardiovascular disease, and lowers risk of death in a group of adults 50 years and older with high blood pressure. This is according to the initial results of a landmark clinical trial sponsored by the National Institutes of Health called the Systolic Blood Pressure Intervention Trial (SPRINT). The intervention in this trial, which carefully adjusts the amount or type of blood pressure medication to achieve a target systolic pressure of 120 millimeters of mercury (mm Hg), reduced rates of cardiovascular events, such as heart attack and heart failure, as well as stroke, by almost a Blood pressure 1third and the risk of death by almost a quarter, as compared to the target systolic pressure of 140 mm Hg.

“Our results provide important evidence that treating blood pressure to a lower goal in older or high-risk patients can be beneficial and yield better health results overall.”

Lawrence Fine, M.D.
Chief, Clinical Applications and Prevention Branch at NHLBI

“This study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50,” said Gary H. Gibbons, M.D., director of the National Heart, Lung, and Blood Institute (NHLBI), the primary sponsor of SPRINT. “We are delighted to have blood pressure 3achieved this important milestone in the study in advance of the expected closure date for the SPRINT trial and look forward to quickly communicating the results to help inform patient care and the future development of evidence-based clinical guidelines.”

High blood pressure, or hypertension, is a leading risk factor for heart disease, stroke, kidney failure, and other health problems. An estimated 1 in 3 people in the United States has high blood pressure.

The SPRINT study evaluates the benefits of maintaining a new target for systolic blood pressure, the top number in a blood pressure reading, among a group of patients 50 years and older at increased risk for heart disease or who have kidney disease. A systolic pressure of 120 mm Hg, maintained by this more intensive blood pressure intervention, could ultimately help save lives among adults age 50 and older who have a combination of high blood pressure and at least one additional risk factor for heart disease, the investigators say.

The SPRINT study, which began in the fall of 2009, includes more than 9,300 participants age 50 and older, recruited from about 100 medical centers and clinical practices throughout the United States and Puerto Rico. It is the largest study of its kind to date to examine how maintaining systolic blood pressure at a lower than currently recommended level will impact cardiovascular and kidney diseases. NIH stopped the blood pressure intervention earlier than originally planned in order to quickly disseminate the significant preliminary results.

The study population was diverse and included women, racial/ethnic minorities, and the elderly. The investigators point out that the SPRINT study did not include patients with diabetes, prior stroke, or polycystic kidney disease, as other research included those populations.

Source: NIH

hyper 3A growing stack of medical research—including Gottesman’s recent study—suggests that high blood pressure raises risk for thinking problems, early brain aging, and even Alzheimer’s disease. These three steps may help reduce risk:

Know your number. “Have your blood pressure checked regularly,” Gottesman says. “People tend to ignore high blood pressure, particularly when they are younger, because it has no symptoms that you can feel or see. But it’s important to pay attention to it.”

Take care of higher-than-normal blood pressure right away. Talk with your doctor about what Hyperblood pressure is appropriate for you. If yours is higher than recommended, your doctor will advise you take lifestyle steps such as weight loss, regular exercise, and a lower-sodium diet that features plenty of fruits and vegetables to bring it down to a healthier level. Your doctor may also prescribe drugs that lower blood pressure.

If your doctor prescribes medications for your blood pressure, take as directed. Nearly half of all people with high blood pressure don’t have it hyper 2under control, according to the Centers for Disease Control and Prevention. One big reason: skipping medication or not taking it as directed.

It’s long been known that keeping your blood pressure within a healthy range helps protect against heart attack and stroke. Now a recent study from Johns Hopkins University has uncovered a new risk worth sidestepping: People with high blood pressure at midlife had greater decline in key thinking skills late in life than those with normal blood pressure readings.

Source: Johns Hopkins Medicine

heart 3Men who slept badly were twice as likely to suffer a heart attack and up to four times as likely to have a stroke compared with those who slept well, according to a Russian study presented at EuroHeartCare.

“Sleep disorders are very closely related to the presence of cardiovascular diseases. However, until now there has not been a population based cohort study examining the impact of sleep disorders on the development of a heart attack or stroke,” lead investigator Valery Gafarov, MD, PhD, professor of cardiology at the Russian Academy of Medical Sciences in Novosibirsk, said in a press release.

The study included 657 men ages 25 to 64 with no history of cardiovascular disease or diabetes. They were enrolled in 1994 as part of the World Health Organization’s MONICA (multinational monitoring of trends and determinants in cardiovascular disease) project.sleep

Sleep quality was assessed at baseline with the MONICA-psychosocial interview sleep disturbances scale. Incidence of new cases of myocardial infarction (MI) and stroke were determined at 5 years, 10 years, and 14 years of follow-up. The investigators used Cox proportional regression models to estimate hazard ratios.

Compared with men who rated their sleep as “good,” those who rated it “poor” or “very bad” had more than twice the risk of experiencing MI at 5 years.

This increased risk for MI was also seen at 10 years and at 14 years of follow-up.heart 2

Nearly two-thirds (63%) of the men experiencing their first MI described their sleep as “poor” or “very bad.”

Compared with men who rated their sleep as “good,” those who rated it “poor” or “very bad” had nearly quadruple the risk of stroke at 5 years.

Source: Medpage Today

air pollution 3Air pollution is known to increase the risk for stroke and other cerebrovascular disorders. But now researchers have found it is also linked to premature aging of the brain.

The study, in the May issue of Stroke, used data on 943 men and women over 60 who were participants in a larger health study. Researchers did M.R.I. examinations and gathered data on how close the people lived to major highways. They also used satellite data to measure particulate matter smaller than 2.5 micrometers, or PM 2.5, a form of pollution that easily enters the lungs and bloodstream.air pollution 1

After controlling for health, lifestyle and socioeconomic factors, they found that compared with people exposed to the lowest levels of PM 2.5, those with the highest exposure had a 46 percent increased risk for covert brain infarcts, the brain damage commonly called “silent strokes.”

They also found that each additional two micrograms per cubic meter increase in PM 2.5 was linked to a decrease in cerebral brain volume equivalent to air pollution 2about one year of natural aging.

“We’re seeing an association between air pollution and potentially harmful attacks on the brain,” said the lead author, Elissa H. Wilker, a researcher at Beth Israel Deaconess Medical Center. “This helps us to better understand the mechanisms related to air pollution and clinically observed outcomes.”

Source: New York Times

foilc 2Hypertension is the primary risk factor for stroke.  However, none of the previously reported trials compared blood pressure control over the treatment period. Our trial attempted to ensure the comparability of blood pressure levels between the treatment groups both at baseline and throughout follow-up, during which blood pressure control was achieved using a standard protocol of enalapril, 10 mg/d, plus other folic3antihypertensive agents as needed. As such, the CSPPT lends further support that folic acid therapy can lead to an additional 21% risk reduction of first stroke compared with antihypertension treatment alone. A synergy of enalapril (an Folicangiotensin-converting enzyme inhibitor) with folic acid is possible based on the findings of a subanalysis in the WAFACS trial.

Inadequate folate intake is prevalent in most countries without mandatory folic acid fortification, including in Asia and other continents. The MTHFR 677 TT variant, which leads to a 60% reduction in the enzyme function, is present in all populations but with variable frequency (usually 2%-25%).  Based on recently published US National Health and Nutrition Examination Survey folate data and our unpublished folate data from the Boston Birth Cohort, there is substantial variability in blood folate levels within the US population and across racial/ethnic groups. We speculate that even in countries with folic acid fortification and widespread use of folic acid supplements such as in the United States and Canada, there may still be room to further reduce stroke incidence using more targeted folic acid therapy—in particular, among those with the TT genotype and low or moderate folate levels.

Source: JAMA

pollution 1Air pollution — even for just one day — significantly increases the risk of stroke, a large review of studies has found.

Researchers pooled data from 103 studies involving 6.2 million stroke hospitalizations and deaths in 28 countries.

The analysis, published online in BMJ, found that all types of pollution except ozone were associated with increased risk for stroke, and the higher the level of pollution, the more strokes there were.

Daily increases in pollution from nitrogen dioxide, sulfur dioxide, carbon monoxide and particulate matter were associated with corresponding increases in strokes and hospital admissions. The pollution 3strongest associations were apparent on the day of exposure, but increases in particulate matter had longer-lasting effects.

The exact reason for the effect is unclear, but studies have shown that air pollution can constrict blood vessels, increase blood pressure and increase the risk for blood clots. Other research has tied air pollution to a higher risk of heart attacks, stroke and other ills.

Source: New York Times

smoking 4Mortality among current smokers is 2 to 3 times as high as that among persons who never smoked. Most of this excess mortality is believed to be explained by 21 common diseases that have been formally established as caused by cigarette smoking and are included in official estimates of smoking-attributable mortality in the United States. However, if smoking causes additional diseases, these official estimates may significantly underestimate the number of deaths attributable to smoking.

We pooled data from five contemporary U.S. cohort studies including 421,378 men and 532,651 women 55 years of age or older. Participants were followed from 2000 through 2011, and relative risks and 95% confidence intervals were estimated with the use of Cox proportional-hazards models adjusted for age, race, educational level, daily alcohol consumption, and cohort.Smoking 2

During the follow-up period, there were 181,377 deaths, including 16,475 among current smokers. Overall, approximately 17% of the excess mortality among current smokers was due to associations with causes that are not currently established as attributable to smoking. These included associations between current smoking and deaths from renal failure, intestinal ischemia, hypertensive heart disease, infections, various respiratory smoking 3diseases, breast cancer, and prostate cancer. Among former smokers, the relative risk for each of these outcomes declined as the number of years since quitting increased.

A substantial portion of the excess mortality among current smokers between 2000 and 2011 was due to associations with diseases that have not been formally established as caused by smoking. These associations should be investigated further and, when appropriate, taken into account when the mortality burden of smoking is investigated.

Source: The New England Journal of Medicine

Sleep apnea is a potential health risk for millions of Americans, and a new study points to a possible culprit behind the disorder: a “fat” tongue.

“This is the first study to show that fat deposits are increased in the tongue of obese patients with obstructive sleep apnea,” study senior author Dr. Richard Schwab, co-director of the Sleep Center at the University of Pennsylvania Medical Center, said in a news release from Sleep, which will publish the findings Oct. 1.Sleep Apnea Tongue

Sleep apnea is a common disorder in which the airways constrict during sleep, leading to repeated stops and starts in breathing. The telltale signs include chronic loud snoring, with periodic gasps or choking — and, for many people, daytime drowsiness because of poor sleep.

But the effects go beyond fatigue. Studies suggest those pauses in breathing stress the nervous system, boosting blood pressure and inflammation in the arteries.

Obese people tend to be at higher risk for sleep apnea, and Schwab’s team say the new findings may help explain the link between obesity and the breathing disorder.

The study included 90 obese adults with sleep apnea and 90 obese adults without the disorder.

The participants with sleep apnea had significantly larger tongues, tongue fat and percentage of tongue fat than those without sleep apnea, the researchers found. The tongue fat in the people with sleep apnea was concentrated at the base of the tongue.

Sleep ApneaIn addition to increasing the size of the tongue, higher levels of tongue fat may prevent muscles that attach the tongue to bone from positioning the tongue away from the airway during sleep, Schwab’s group explained.

While the study found an association between tongue fat content and sleep apnea, it could not prove cause and effect.

However, the researchers believe future studies should assess whether removing tongue fat through weight loss, upper airway exercises or surgery could help treat sleep apnea.

“Tongue size is one of the physical features that should be evaluated by a physician when screening obese patients to determine their risk for obstructive sleep apnea,” American Academy of Sleep Medicine President Dr. Timothy Morgenthaler added in the news release.

“Effective identification and treatment of sleep apnea is essential to optimally manage other conditions associated with this chronic disease, including high blood pressure, heart disease, type 2 diabetes, stroke and depression,” he said.

Nearly 35 percent of U.S. adults — 78.6 million people — are obese, according to the U.S. Centers for Disease Control and Prevention.

Source: Detroit Free Press

The Presidential Healthcare Center now offers home sleep studies.  

In an analysis of cohort studies, a history of kidney stones was associated with an increased risk for coronary heart disease (CHD) and stroke. The data suggest that the risk may be higher in women than men.

The studies included close to 50,000 patients with kidney stones and 3.56 million controls. Results found kidney stone history to be associated with a 19% greater risk for CHD and a 40% greater risk for stroke. Additionally, women showed a statistically significant increased risk for myocardial infarction, while men did not.

The researchers noted that a lack of studies separately evaluating for effect modification by sex, along with other limitations, could explain the risk difference among men and women. Though, they added that several recent studies have shown a gender difference in kidney stone-related CHD and stroke risk.

One was reported in JAMA in July 2013. kidney stones

The prospective study included 45,748 men and 196,357 women in the U.S. without a history of CHD at baseline, including 19,678 who reported a history of kidney stones. Two cohorts of women and one of men were followed for up to 24 years.

The study found that women with a history of kidney stones had about an 18% increased risk for CHD and a 48% increased risk compared with women who had never had a kidney stone.

An even larger study from Alberta, Canada, reported in March of this year, showed similar differences in risk by gender.

The study included close to 3.2 million people registered in Alberta’s universal healthcare system between 1997 and 2009 who were followed for a median of 11 years.

The study showed that people who had at least one kidney stone had a 40% higher risk for heart attack, a 63% higher risk for blockage of blood flow to the heart and other organs, and a 26% higher risk for stroke. The magnitude of increased risk appeared more pronounced for women than men.

Both studies were included in the newly-published meta-analysis.

Gary C. Curhan, MD, who was a co-author on both, said the new data make a strong case for a real gender difference in cardiovascular disease risk associated with kidney stone history.

Curhan is a professor of medicine at Harvard Medical School and a renal disease specialist at Brigham and Women’s Hospital, Boston.

“The risk certainly seems to be higher in women than men, but I would not say the risk is zero in men.” “These two studies give us more confidence that this association is real. The next step is to try and answer the question ‘Why is there a difference?'”

Source: medpage Today

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