Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, August 28, 2016

Low socioeconomic status associated with higher risk of second heart attack or stroke

I can't quite see how your doctor is going to address this risk factor.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=167321&CultureCode=en

Low socioeconomic status is associated with a higher risk of a second heart attack or stroke, according to research presented at ESC Congress 2016 today.1 The study in nearly 30 000 patients with a prior heart attack found that the risk of a second event was 36% lower for those in the highest income quintile compared to the lowest and increased by 14% in divorced compared to married patients.
Lead author Dr Joel Ohm, a physician at the Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden, said: “Are you rich or poor? Married or divorced? That might affect your risk of a second heart attack or stroke. Advances in prevention and acute treatment have increased survival after heart attack and stroke over the past several decades. The result is that more people live with cardiovascular disease – in Sweden almost one fifth of the total population is in this group.”
Most research on cardiovascular prevention is based on healthy people and it is unclear if the findings apply to patients with established disease. An association between socioeconomic status in healthy individuals and future cardiovascular disease was found in the 1950s. This study investigated the link between socioeconomic status in patients who had survived a first heart attack and the risk of a second heart attack or a stroke.
The study included 29 953 patients from the Swedish nationwide registry, Secondary Prevention after Heart Intensive Care Admission (SEPHIA), who had been discharged approximately one year previously from a cardiac intensive care unit after treatment for a first myocardial infarction. Data on outcome over time and socioeconomic status (defined as disposable income, marital status and level of education) was obtained from Statistics Sweden and the National Board of Health and Welfare.
During an average follow up of four years, 2405 patients (8%) suffered a heart attack or stroke. After adjusting for age, gender, smoking status, and the defined measures of socioeconomic status, being divorced was independently associated with a 14% greater risk of a second event than being married. There was an independent and linear relationship between disposable income and the risk of a second event, with those in the highest quintile of income having a 36% lower risk than those in the lowest quintile (figures 1 and 2). A higher level of education was associated with a lower risk of events but the association was not significant after adjustment for income.
Dr Ohm said: “Our study shows that in the years following a first myocardial infarction, men and women with low socioeconomic status have a higher risk of suffering another heart attack or stroke. This is a new finding and suggests that socioeconomic status should be included in risk assessment for secondary prevention after a heart attack. Even though health care providers are unlikely to keep track of their patients’ yearly salary, simple questions about other socioeconomic variables such as marital status and educational level could make a difference.”
According to the widely used assessment tools for cardiovascular risk, survivors of heart attacks are at the highest possible risk for subsequent events regardless of other risk factors. There is, for example, no difference in estimated risk level between a previously healthy 40-year old female from Spain and a heavily smoking, obese, elderly man with diabetes and high blood pressure from Finland.
Dr Ohm said: “Risk assessment tools are designed for individuals without previous cardiovascular disease and the calculations may not apply to patients with established cardiovascular disease. Socioeconomic status is perhaps a better marker to assess risk of future events in heart attack patients and more research is needed to determine other factors that could be included, such as occupation or residential area.”
Figure 1. Relationship between disposable income and risk of a second heart attack or stroke.
Results are adjusted for age, gender, smoking and other socioeconomic variables (marital status and education level).
Figure 2. Proportion of patients free of a second incident heart attack or stroke (ASCVD or atherosclerotic cardiovascular disease) during follow-up time by quintiles of disposable income.

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