Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, October 13, 2016

High blood pressure and brain health are linked

I had high blood pressure for 9 months before getting it under control. Is that enough time to  get me cognitively impaired? I'm obviously either impaired or delusional right now with my thinking that the stroke medical world is completely incompetent and I alone could direct a much better job than whomever is leading this right now. Maybe a little bit narcissistic there?
http://www.alphagalileo.org/ViewItem.aspx?ItemId=168611&CultureCode=en
High blood pressure, especially in middle age, is associated with an increased risk of cognitive impairment later in life, according to a new statement from the American Heart Association.
The statement, which was published in the American Heart Association journal Hypertension,reviewed multiple studies and provides an overview of what is currently known about how high blood pressure influences brain diseases such as stroke, vascular cognitive impairmentand Alzheimer’s disease.
“Many observational studies suggest treating hypertension may reduce the cognitive impact of high blood pressure, especially on vascular cognitive impairment, but observational studies are not designed to prove cause and effect,” said Costantino Iadecola, M.D., chair of the writing committee.
Vascular cognitive impairment describes a range of changes in brain function, from mild to severe, caused by the impaired flow of blood to the brain.
“We know treating high blood pressure reduces the risk of heart diseases such as heart attacks, congestive heart failure and stroke, and it is important to continue treating it to reduce the risks of these diseases.  However, we need randomized controlled studies – which do prove cause and effect – to determine if treating high blood pressure, especially in middle age, will also decrease the risk of cognitive impairment later in life,” Iadecola said.
Most of the clinical trials the writing committee reviewed did not directly investigate the effect of high blood pressure on cognition, which made it impossible to draft a statement that would give healthcare providers guidance on how to treat patients with dementia, Iadecola said, who is also Anne Parrish Titzell Professor of Neurology and director of the Brain and Mind Research Institute at Weill Cornell Medical College.
One of the issues researchers face is that there are years between the time a patient has high blood pressure and when the cognitive problems arise, so long-term studies addressing questions such as when to start treatment aimed at protecting the brain, the level of blood pressure that should be achieved and which medications are recommended is difficult to pinpoint.
Dementia, one of the most common neurological disorders, affects an estimated 30 to 40 million people worldwide. The number of people with dementia is anticipated to triple worldwide by 2050 due to the aging of the population, shifts in demography and lack of treatments, with an associated cost exceeding $1.1 trillion.
The two leading causes of cognitive impairment are Alzheimer’s disease and vascular cognitive impairment, which account for approximately 80 percent of cases. Often, patients suffering from dementia have a mixture of the two.
“The SPRINT-MIND trial, a new study that is designed to evaluate the role of treating high blood pressure relative to cognitive impairment, may provide answers to some of the outstanding questions about treating high blood pressure relative to reducing the risk of cognitive impairment,” said Iadecola.
Until then, Iadecola recommends treating high blood pressure on an individual basis in patients to protect brain, heart, and kidney.
Co-authors are Kristine Yaffe, M.D., co-chair; José Biller, M.D.; Lisa C. Bratzke, Ph.D.; Frank M. Faraci, Ph.D.; Philip B. Gorelick, M.D.; Martha Gulati, M.D., M.S.; Hooman Kamel, M.D.; David S. Knopman, M.D.; Lenore J. Launer, M.D.; Jane S. Saczynski, Ph.D.; Sudha Seshadri, M.D. and Adina Zeki Al Hazzouri, Ph.D. Author disclosures are on the manuscript.
http://newsroom.heart.org/news/high-blood-pressure-and-brain-health-are-linked?preview=1cbfda7287aaed05475daf5b670552f6

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