Stroke
Folic acid won’t cut heart, stroke risk, study says
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Taking a folic acid supplement does not cut the risk of heart disease or stroke in people with a history of cardiovascular ailments, according to a study published on Tuesday.
Folic acid, also called folate, is a B vitamin. The body uses it to make new cells. Some doctors have recommended the vitamin to ward off cardiovascular disease, the leading cause of death in the United States.
Occupational therapy benefits stroke patients
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Occupational therapy helps stroke patients recover their ability to care for themselves and also keeps them independent longer, according to a new scientific review of the best available data.
“The most important finding is that occupational therapy works,” Dr. Lynn Legg of the Glasgow Royal Infirmary in Scotland, the study’s lead author, said in a press release accompanying the study. “Very few interventions have had such an impact.”
Legg’s group points out that more information is needed the answer questions such as which occupational therapy approaches are the most effective, how long therapy should be offered, and how often patients should have it.
Strength training won’t harm older arteries
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Despite some concerns to the contrary, strengthening exercises appear to help, not harm, older adults’ artery function, a small study suggests.
In general, experts advise that young and old alike include both aerobic activities and strength training in their exercise routines. For older adults, the benefits may include stronger muscles and bones, fewer physical limitations and a lower risk of falls and fractures.
However, research in young adults has found that strength-building resistance exercises seem to increase “stiffness” in the arteries—effects that would be concerning in older adults, whose risk of heart disease and stroke is already elevated.
Study warns of dangers of stents to prevent strokes
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Propping open clogged arteries with little mesh tubes called stents is more likely to cause strokes than the old-fashioned method of simply cleaning out the arteries surgically, a French study showed on Wednesday.
Stents were found to be so dangerous that just over a year ago, the team led by Jean-Louis Mas of Sainte-Anne Hospitals in Paris stopped enrolling volunteers in the study, begun in November 2000, because of risks from the stent technique.
The work, published in The New England Journal of Medicine, reflects international efforts to determine the best treatment for clearing clogged carotid arteries—the most common cause of the strokes suffered by over 700,000 Americans each year.
Stroke symptoms common among undiagnosed patients
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More than one in six people who have never been diagnosed with a stroke or with a transient ischemic attack (TIA) have experienced stroke symptoms, according to a report in the Archives of Internal Medicine.
A TIA is an episode in which the blood flow to the brain is briefly interrupted, causing stroke-like symptoms that usually last only a few minutes. On the other hand, in strokes the brain blood flow is blocked to a greater extent, leading to more serious deficits, permanent disability or death.
“Coupled with previous reports showing a substantially increased risk of a subsequent stroke in those with stroke symptoms and a substantial prevalence of ‘silent stroke’ according to MRI, our findings suggest that these commonly reported symptoms may be mild strokes that failed to reach the threshold for clinical diagnosis,” lead author Dr. Virginia J. Howard, from the University of Alabama at Birmingham, and colleagues note.
High Hourly Air Pollution Levels More than Double Stroke Risk
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High hourly levels of air pollution, more than double the risk of one type of stroke, suggests research published ahead of print in Occupational and Environmental Medicine.
Currently, the risk of respiratory and cardiovascular problems tends to be linked to the average daily amount of air pollution, rather than variations in hourly levels.
The researchers assessed data on stroke deaths in people aged 65 years and older, occurring between January 1990 and December 1994 in 13 major urban areas in Japan.
Internal body clock dictates timing of different types of stroke
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The internal body clock, or circadian rhythm, seems to influence the timing of different types of stroke, suggests research published ahead of print in the Journal of Neurology Neurosurgery and Psychiatry.
The research team analysed data from almost 13,000 patients who had had one of three types of stroke for the first time, diagnosed by brain scan.
These patients’ data had been collected on a stroke register, showing that cerebral infarction, where blood flow to brain arteries is restricted, was the most common type of stroke. The rate was 89 per 100,000 of the population.
Cost of stroke in U.S. expected to skyrocket
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The cost of treating people who suffer strokes in the U.S. is projected to exceed $2 trillion between 2005 and 2050, according to new estimates.
The researchers who came up with this estimate hope that the figure will spur improvements in stroke prevention and treatment, particularly in underserved populations.
For their analysis, reported in the journal Neurology, Dr. D. L. Brown, from the University of Michigan in Ann Arbor, and colleagues used data from two stroke surveillance studies and from the 2000 US Census. They added in the cost of ambulance services, inpatient hospitalization and rehabilitation, nursing home care, drugs and outpatient services. Also included were costs of informal caregiving, and potential lost earnings.
Lipitor reduces stroke risk
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In people who have experienced a stroke, but who have no known history of coronary heart disease, beginning regular treatment with the cholesterol-lowering drug atorvastatin soon after the stroke can reduce the risk of recurrent stroke by 16 percent, according to a five-year study led by an international team that includes a researcher at Duke University Medical Center.
The results of the study, called the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial, appear in the August 10, 2006, issue of the New England Journal of Medicine. The study was funded by Pfizer, the manufacturer of atorvastatin.
“This is the first study to demonstrate that treatment with a statin, a type of cholesterol-lowering drug, can reduce the risk of strokes in patients who have had a recent stroke or a transient ischemic attack and who have no known history of coronary heart disease,” said Larry B. Goldstein, M.D., director of the Duke Stroke Center and a member of the SPARCL steering committee.
Severe sleep apnea raises stroke risk in elderly
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Elderly people who have severe sleep apnea are at more than double the risk of having a stroke, even after accounting for other known risk factors for stroke, according to a new report.
Sleep apnea occurs when breathing is briefly but frequently blocked while someone is sleeping. Loud, abrupt snoring is often a sign that this is happening.
In a number of studies, sleep apnea has shown to be related to stroke, Dr. Roberto Munoz, from Hospital de Navarra in Spain, and colleagues note in the medical journal Stroke. However, elderly subjects have largely been excluded from these studies.
Healthy Lifestyle Reduces Women’s Stroke Risk
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Women who are non-smokers, exercise regularly, have a healthy diet, including moderate alcohol consumption, and otherwise live a healthy lifestyle may have a reduced risk of stroke, according to a report in the July 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
About 700,000 strokes occur each year in the United States, approximately one-fourth of which are fatal and an additional one-fourth of which leave patients permanently disabled, according to background information in the article. There are two main types of stroke: ischemic, the more common type, in which a blocked artery causes a lack of blood flow to the brain; and hemorrhagic, which occurs when a ruptured blood vessel causes blood to leak into the brain. Several individual risk factors, including smoking, exercise and body mass index (BMI), have been linked to stroke. However, in contrast to studies assessing risk for heart disease and diabetes, researchers have not previously examined how the combination of these behaviors may contribute to stroke.
Aspirin use not seen linked to stroke severity
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When a stroke occurs, its severity does not seem to be related to whether the patient had be taking aspirin previously or not, according to a large, international study.
“Several reports have suggested that patients who have (a) stroke while taking aspirin have less severe strokes than those not on such pretreatment, whereas others have suggested either no effect or an increase of stroke severity,” Dr. Stefano Ricci, of UOCD Neurologia e Ictus, Perugia, Italy, and colleagues write in the medical journal Stroke.
To investigate further, they examined the effects of previous aspirin use on the severity of stroke in patients who were enrolled in the International Stroke Trial, which tested the benefits of different treatments after a stroke.
Which inflammatory markers predict the appearance of a stroke?
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Patients that have suffered from a stroke have a higher risk of a similar event happening and, in consequence, greater possibilities of dying.
For the first time, 52 hospitals in Spain, three of which (Basurto; Cruces and Bidasoa) in the Basque country, are participating in a study to determine if certain concrete inflammation markers can be linked to the appearance of a new stroke or other vascular events such as myocardiac arrest. The M?ICO study was presented at the IV International Meeting on Isquemic Ictus.
The study included patients from different Autonomous Communities and that had suffered a stroke one to three months previously. By means of periodical controls, a number of inflammation markers found in the plasma (interleucines, metalloproteases, fibronectines) were studied over a period of a year. “We know that that there are certain inflammation markers that can contribute to patients suffering from new strokes or other vascular events such as heart attack. In fact, those who have chronic mouth infections or inflammatory processes have a greater risk of repeating these illnesses”, explains doctor José Castillo, coordinator of the M?ICO project.
Gum disease may up stroke risk
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Making regular visits to the dentist not only protects the teeth, it also may protect the carotid arteries—the main blood vessels leading to the brain.
Study findings presented this past weekend in Brisbane, Australia at a gathering of the International Association for Dental Research hint that gum disease may contribute to clogged carotids, leading to an increased risk of stroke.
Chronic inflammation arising from dental disease has been implicated in the development of atherosclerosis or hardening of the arteries—a key risk factor for stroke. Advanced carotid artery blockages contain calcium, and can be imaged when a dentist takes a panoramic x-ray of the teeth.
Magnetic stimulation helps with stroke rehab
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As a rehabilitation technique for stroke, repetitive magnetic stimulation of the brain, or “rTMS,” can improve patient movement on the side of the body affected by the stroke.
With rTMS, a magnet is used to slow nerve activity on the side of the brain not affected by the stroke. Previous research has suggested that after a stroke, the unaffected side becomes hyperactive, sending signals to the affected side that actually impair the patient’s ability to move the arms and legs.
The findings, from a study reported in the journal Stroke, indicate that the magnitude and duration of movement benefits can be safely increased after more than one rTMS session. With five consecutive sessions, sustained improvements in movement in stroke patients were noted over the 2-week study period.
