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.

Monday, September 13, 2021

AHA issues recommendations for patients with CVD planning high-altitude activities

Make sure you question your doctor on the benefits of high altitude living.

But then since you do not have a cardiovascular disease(stroke has been called neurological by the WHO since 2006) this may not apply to you.

High altitudes for Training the Brain to Survive Stroke.

Long lived Georgia O'Keefe at 7000 feet;

HOW TO LIVE TO (NEARLY) 99 IN FULL HEALTH…

The latest here:

AHA issues recommendations for patients with CVD planning high-altitude activities

Because sudden cardiac death can occur in patients with CVD traveling to higher altitudes, experts recommended in a new American Heart Association scientific statement that patients with CVD consult a physician before travel.

“Many people and health care professionals are familiar with symptoms of acute mountain sickness like headaches, dizziness, nausea and weakness. However, they may be less aware of the stress placed on the body — and particularly the heart and lungs, when people with cardiovascular disease travel to mountainous regions where there is a reduction in oxygen availability compared to sea-level conditions. If people are not prepared, they may be at an increased risk of adverse events in these types of environments,” William K. Cornwell III, MD, MSCS, FAHA, assistant professor of cardiology at the University of Colorado School of Medicine and chair of the scientific statement writing group, said in a press release. “This concise overview of how altitude impacts patients with cardiovascular disease provides additional information to help guide clinicians in advising their patients on best practices for safe travel to higher altitudes and mountainous regions.”

Considerations for patients with CVD planning high-altitude activities
Because sudden cardiac death can occur in patients with CVD traveling to higher altitudes, experts recommended in a new AHA scientific statement that patients with CVD consult a physician before travel. Data were derived from Cornwell WK 3rd, et al. J Am Heart Assoc. 2021;doi:10.1161/JAHA.121.023225.

According to the statement, high-altitude exposure is associated with lower blood-oxygen content caused by reduced atmospheric pressure and partial pressure of oxygen, creating a hypoxic environment. High-altitude activities can require increased oxygen demand, which is a challenge to overcome in relatively oxygen-deprived environments.

In the presence of acute hypoxia, individuals can experience systemic arterial vasodilatation, hypoxic pulmonary vasoconstriction and activation of peripheral chemoreceptors. These physiological responses can have downstream effects, including sympathetic activation, which increases BP and cardiac output, as well as hyperventilation and pulmonary hypertension, the committee wrote.

Effects of high-altitude activities

“More than 100 million people travel to mountainous environments yearly for work or pleasure. Mountain activities frequently involve exercise, which, when combined with environmental changes such as temperature, humidity, pressure and oxygen availability, place unique challenges on the cardiovascular system,” the committee wrote. “Medical resources are frequently limited, which may compromise outcomes following adverse events. Therefore, it is incumbent on clinicians to understand the unique physiologic challenges associated with exercising in hypoxic environments.”

The committee identified the following CVD states that, if identified in a patient planning high-altitude travel, increase risk for CV events at high altitude:

In patients with CAD, atherosclerosis can cause paradoxical vasoconstriction of coronary vessels in response to increased oxygen demand from exercise combined with altitude-related hypoxia. Moreover, acute hypoxia may exacerbate angina symptoms.

In hypertension, high-altitude exposure causes an initial reduction in BP associated with hypoxia-related systemic vasodilation; however, the initial reduction is counteracted by chemoreflex-mediated vasoconstriction, causing BP elevation. This risk in BP is primarily driven by increased oxygen content due to high-altitude acclimatization.

In patients with rhythm disorders or at risk for sudden cardiac death, acute hypoxia may trigger an arrhythmic event. According to the statement, prior observational studies showed that more than 50% of sudden cardiac deaths at altitude occur within the first day of exposure.

Physiological responses to hypoxia, including sympathetic nerve activation, elevated systemic and pulmonary arterial pressures, tachycardia, increased lung fluid content and reductions in stroke volume, may worsen symptoms in patients with HF with reduced ejection fraction. In addition, HF therapies such as carvedilol, diuretics and acetazolamide may inhibit exercise tolerance at altitude. According to the statement, there are no published studies on altitude tolerance among patients with HF with preserved ejection fraction; however, patients with HFpEF are likely to have elevated pulmonary arterial pressure, hypertension and atrial fibrillation at sea level, so heart-rate and BP control at altitude may be important.

 

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