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

Monday, July 24, 2017

Study finds increased risk of death, heart attack in people who survive stroke without complications

Pretty much totally useless. they don't refer to any protocols at all on stroke prevention, just generic crap. I'm past this 5 year window so hopefully I'm good until I die at age 104, 43 years of fun to go yet.
http://www.news-medical.net/news/20170724/Study-finds-increased-risk-of-death-heart-attack-in-people-who-survive-stroke-without-complications.aspx
People who survive a stroke or a mini-stroke without early complications have an increased risk of death, another stroke or heart attack (myocardial infarction) for at least 5 years following the initial stroke, found a new study published in CMAJ (Canadian Medical Association Journal)
"There is a real need to maintain risk reduction strategies, medical support and healthy lifestyle choices over the long-term, even years after a mild initial event," said senior author Dr. Richard Swartz, a neurologist at Sunnybrook Health Sciences Centre, Toronto, Ontario.
Many studies show an elevated risk over time, although most have included patients with complications in the early 90-day high-risk period and not survivors without complications in the period following stroke or transient ischemic attack (TIA).
A TIA is a mini-stroke which usually resolves quickly but indicates that a patient is at high-risk of a full stroke. The risk of stroke after TIA is highest in the first 90 days, but this study shows that there continues to be an increased risk even after years of stability.
"These analyses indicate that survival after both stroke and TIA is a marker of long-term risk, which merits aggressive attention to risk reduction strategies," write the authors.
The study included 26 366 patients who had been discharged after stroke or TIA without complications in the first 90 days at regional stroke centers in Ontario between July 2003 and March 2013, and 263 660 matched controls. Researchers found that in the patient group who did not experience complications in the post-stroke period, the risk of complications was significantly higher over the long term compared with the controls. At 1 year, 9.5% of people experienced an adverse event such as death, stroke, heart attack or admission to long-term care, 23.6% at 3 years and 35.7% at 5 years.
"These findings highlight the need for long-term management of modifiable risks, such as high blood pressure, monitoring, and treatment of irregular heart rhythms, quitting smoking and physical activity," said Dr. Swartz.
Additional options for long-term risk reduction could include tailoring existing cardiac rehabilitation programs for stroke survivors, following patients for years rather than months after their stroke or TIA, and embedding long-term management into primary care practices.
"For survivors of stroke or TIA, the long-term risk of recurrent stroke was particularly high, indicating that stroke recurrence is the most important modifiable outcome," the authors conclude.
In a related commentary http://www.cmaj.ca/lookup/doi/10.1503/cmaj.170410, Dr. Michael Hill, University of Calgary, writes "stroke is under-recognized as a major public health problem and incorrectly considered to be a disease that affects only older people. In North America and Western Europe, stroke is the third or fourth leading cause of death overall, but in the developing world is the first or second, depending on the country."
We must focus on reducing recurrent strokes and death with better post-stroke treatments and long-term follow up.

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