Scientists Explore Ear Nerve Stimulation as Potential Treatment for Uncontrolled Hypertension

 My Dads' hypertension was never controlled.

Scientists Explore Ear Nerve Stimulation as Potential Treatment for Uncontrolled Hypertension

Three Factors Tied to 13 Additional Dementia-Free Years

 Never smoked, hypertension started at age 58(past midlife), no diabetes or pre-diabetes. I should easily get to 100 without dementia(30 years to go).

Three Factors Tied to 13 Additionedal Dementia-Free Years

Key Takeaways

• Midlife vascular health was associated with nearly 13 more dementia-free years in a prospective U.S. cohort study.
• At age 55, healthier study participants averaged 30.1 additional years without dementia.
• Smoking, hypertension, and diabetes together sharply increased dementia risk and mortality.

Maintaining three key health factors during midlife -- normal blood pressure, no diabetes, and not smoking -- was associated with nearly 13 additional dementia-free years, a study of 12,000 people in the U.S. showed.

Individuals who met these criteria at age 55 lived an average 30.1 more years dementia-free, reported Josef Coresh, MD, PhD, of NYU Langone Health in New York City, and co-authors.

Conversely, those who smoked, had hypertension, and had diabetes at age 55 had dementia-free survival of only 17.5 years, Coresh and colleagues wrote in Neurology Open Access.

People with all three risk factors had a higher incidence of dementia (HR 2.69, 95% CI 1.94-3.73) and a higher incidence of dying before a dementia diagnosis (HR 5.61, 95% CI 4.67-6.74) compared with those who had no risk factors.

Overall, women lived longer without dementia than men at all risk levels. White participants had more years free of dementia than Black participants, and APOE4 carriers had shorter dementia-free survival than noncarriers.

"Our findings argue that people need to actively avert these factors in midlife as a strategy for preserving brain health for more than a decade," Coresh said in a statement. "Discovering new ways to delay dementia is crucial with 42% of Americans at risk for developing the condition at any time after age 55."

The findings were based on 12,409 participants in the prospective Atherosclerosis Risk in Communities (ARIC) study, which started in 1986 to evaluate midlife vascular risk factors and late-life dementia.

Previous research from the ARIC cohort suggested that 22% to 44% of dementia risk by age 80 could be attributed to three vascular risk factors measured in midlife and early late life, after accounting for risk factor concurrence and interactions.

Hypertension was defined as systolic blood pressure ≥130 mm Hg, diastolic blood pressure ≥80 mm Hg, or the use of blood pressure medication; diabetes as fasting glucose ≥126 mg/dL, non-fasting glucose ≥200 mg/dL, a physician's diagnosis, or the use of any diabetes medication; and current smoking was self-reported.

"Our study complements this important work by shifting focus from probability-based and attributable risk metrics to a time-based estimand -- dementia-free survival years, which quantifies the expected duration of life lived cognitively intact," Coresh and colleagues wrote.

"This outcome integrates two clinically relevant processes: incident dementia and death before dementia, therefore reflecting the competing risks that shape real-world aging trajectories," they pointed out. "In contrast to previous ARIC studies, this framework emphasizes how vascular health influences the balance between longevity and cognitive health over the life course."

In the current analysis, ARIC participants had a mean baseline age of 56 and 56% were women. Dementia was tracked through cognitive assessments, informant interviews, and continuous surveillance. Deaths without dementia were captured from multiple sources including the National Death Index.

Over a median follow-up of 26.3 years, 3,008 cases of dementia and 5,238 deaths without dementia were documented. Better vascular health was linked with longer dementia-free survival in a dose-response pattern.

"Several biologic pathways likely underlie our observed associations between vascular health and dementia-free survival, including chronic cerebrovascular injury, neuroinflammation triggered by vascular damages through hypertension and diabetes, and cumulative oxidative stress resulting from smoking," Coresh and colleagues wrote. "Together, these factors likely accelerate atherosclerosis, increase stroke risk, and may facilitate Alzheimer's disease pathology through promoting amyloid plaques and tau tangles."

The findings relied on one midlife assessment of risk factors, the researchers acknowledged. Dementia ascertainment may have differed between participants who attended recent visits and those who didn't. In addition, the study was observational and residual confounding may have influenced outcomes.

Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Connect:

Three Factors Tied to 13 Additional Dementia-Free Years

 Ask your competent? doctor how your stroke affects these possibilities! There better be an answer.

Three Factors Tied to 13 Additional Dementia-Free Years

Key Takeaways

• Midlife vascular health was associated with nearly 13 more dementia-free years in a prospective U.S. cohort study.
• At age 55, healthier study participants averaged 30.1 additional years without dementia.
• Smoking, hypertension, and diabetes together sharply increased dementia risk and mortality.

Maintaining three key health factors during midlife -- normal blood pressure, no diabetes, and not smoking -- was associated with nearly 13 additional dementia-free years, a study of 12,000 people in the U.S. showed.

Individuals who met these criteria at age 55 lived an average 30.1 more years dementia-free, reported Josef Coresh, MD, PhD, of NYU Langone Health in New York City, and co-authors.

Conversely, those who smoked, had hypertension, and had diabetes at age 55 had dementia-free survival of only 17.5 years, Coresh and colleagues wrote in Neurology Open Access.

People with all three risk factors had a higher incidence of dementia (HR 2.69, 95% CI 1.94-3.73) and a higher incidence of dying before a dementia diagnosis (HR 5.61, 95% CI 4.67-6.74) compared with those who had no risk factors.

Overall, women lived longer without dementia than men at all risk levels. White participants had more years free of dementia than Black participants, and APOE4 carriers had shorter dementia-free survival than noncarriers.

"Our findings argue that people need to actively avert these factors in midlife as a strategy for preserving brain health for more than a decade," Coresh said in a statement. "Discovering new ways to delay dementia is crucial with 42% of Americans at risk for developing the condition at any time after age 55."

The findings were based on 12,409 participants in the prospective Atherosclerosis Risk in Communities (ARIC) study, which started in 1986 to evaluate midlife vascular risk factors and late-life dementia.

Previous research from the ARIC cohort suggested that 22% to 44% of dementia risk by age 80 could be attributed to three vascular risk factors measured in midlife and early late life, after accounting for risk factor concurrence and interactions.

Hypertension was defined as systolic blood pressure ≥130 mm Hg, diastolic blood pressure ≥80 mm Hg, or the use of blood pressure medication; diabetes as fasting glucose ≥126 mg/dL, non-fasting glucose ≥200 mg/dL, a physician's diagnosis, or the use of any diabetes medication; and current smoking was self-reported.

"Our study complements this important work by shifting focus from probability-based and attributable risk metrics to a time-based estimand -- dementia-free survival years, which quantifies the expected duration of life lived cognitively intact," Coresh and colleagues wrote.

"This outcome integrates two clinically relevant processes: incident dementia and death before dementia, therefore reflecting the competing risks that shape real-world aging trajectories," they pointed out. "In contrast to previous ARIC studies, this framework emphasizes how vascular health influences the balance between longevity and cognitive health over the life course."

In the current analysis, ARIC participants had a mean baseline age of 56 and 56% were women. Dementia was tracked through cognitive assessments, informant interviews, and continuous surveillance. Deaths without dementia were captured from multiple sources including the National Death Index.

Over a median follow-up of 26.3 years, 3,008 cases of dementia and 5,238 deaths without dementia were documented. Better vascular health was linked with longer dementia-free survival in a dose-response pattern.

"Several biologic pathways likely underlie our observed associations between vascular health and dementia-free survival, including chronic cerebrovascular injury, neuroinflammation triggered by vascular damages through hypertension and diabetes, and cumulative oxidative stress resulting from smoking," Coresh and colleagues wrote. "Together, these factors likely accelerate atherosclerosis, increase stroke risk, and may facilitate Alzheimer's disease pathology through promoting amyloid plaques and tau tangles."

The findings relied on one midlife assessment of risk factors, the researchers acknowledged. Dementia ascertainment may have differed between participants who attended recent visits and those who didn't. In addition, the study was observational and residual confounding may have influenced outcomes.

Hypertension, cardiovascular disease, and nocturia: a systematic review of the pathophysiological mechanisms

 Nocturia - Let me google that for you

Mine is usually only once a night.

Hypertension, cardiovascular disease, and nocturia: a systematic review of the pathophysiological mechanisms

• Mitsuru Ohishi,
• Takuro Kubozono,
• Koji Higuchi &
• Yuichi Akasaki 

Hypertension Research volume 44, pages 733–739 (2021)Cite this article

• 2598 Accesses

• 28 Citations

• 4 Altmetric

• Metrics details

Abstract

Nocturia significantly impairs quality of life, especially in the elderly population, and urinary retention is a main target of treatment for urologists. In addition to nocturia, cardiovascular diseases are common in the elderly population, and a systematic review showed that hypertension and heart failure are often associated with nocturia. One possible pathogenic mechanism underlying the development of hypertension is an increase in blood pressure due to excessive salt intake in people with high-salt sensitivity. From Guyton’s natriuretic curve, we can infer that salt-sensitive hypertensive patients who consume too much salt do not excrete salt during the daytime and are forced to excrete salt at night, resulting in increased urine production and nocturia. In patients with heart failure, the nocturnal supine position leads to an increase in central fluid volume due to an increase in venous return from the periphery, and the secretion of natriuretic peptide is stimulated by the stretching of the atria and ventricles. Thus, natriuresis due to hypertension and hydrodiuresis due to heart failure may cause nocturia, which can effectively be treated by the administration of thiazide diuretics and loop diuretics in the morning, respectively. Because cardiovascular diseases, such as hypertension and heart failure, can cause nocturia and because the treatment methods differ depending on the cause, it is necessary to pay close attention to nocturia in the management of lifestyle-related diseases, such as cardiovascular disease.

How a simple salt swap could reduce Aussies’ stroke risk

 Will your incompetent? doctor and hospital know enough to get the dietician to update diet protocols on this?

Do you prefer your doctor, hospital and board of director's incompetence NOT KNOWING? OR NOT DOING?

Of course your competent? doctor told you about the salt controversary years ago, right?

You'll want your competent? doctor to explain all these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

But this:

 

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

And this:

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home.  So, this China study may not have much relevance in your country.

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial January 2018

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease December 2014

Why Everything We Know About Salt May Be Wrong May 2017 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT!

 

 The latest here:

How a simple salt swap could reduce Aussies’ stroke risk

Aussies have been urged to shake things up in the kitchen and at the dinner table by making a simple swap that could reduce their risk of high blood pressure (hypertension); the leading cause of preventable death in Australia.

A new paper by Australia’s National Hypertension Taskforce recommends substituting regular salt, which is high in sodium, with potassium-enriched salt, saying the switch can significantly reduce high blood pressure and the risk of stroke and heart attacks, particularly for people already living with hypertension.

National Hypertension Taskforce member and Stroke Foundation Chief Executive Officer, Dr Lisa Murphy, says this small change can make a big difference.

“Your traditional Sunday roast or summer barbecue will still taste the same but will be better for your health. Research shows us that high sodium consumption is linked to hypertension so replacing sodium with potassium, an important mineral found in fruit and vegetables, is a simple but effective way to reduce your risk. And to make life easier, you can find potassium-enriched salt at your local supermarket.”

A recent global modelling study on the health effects of switching from regular salt to potassium-enriched salt by The George Institute of Global Health found replacing regular salt with potassium-enriched salt in Australia alone could prevent approximately 500 stroke deaths and 2,000 stroke events each year.

“This recommendation aligns with the latest international guidance from the World Health Organization, the European Society of Cardiology, and the American Heart Association, and has the potential to save thousands of Australian lives,” Dr Murphy said.

High blood pressure affects around one in three Australian adults and remains the leading cause of preventable death and disability nationwide. Excess sodium and insufficient potassium intake are key dietary drivers. Despite the strong evidence supporting the benefits of potassium-enriched salt, it is inconsistently recommended by clinicians and rarely used by patients.

“This is due mostly to clinicians and patients being unaware of the availability, effectiveness and acceptability of potassium-enriched salt and we want to change that,” Dr murphy said.

It is hoped the taskforce’s position, published in the National Journal of Hypertension, paves the way for the recommendations to be adopted more widely and marks an important step forward in the national effort to prevent and control hypertension.

The National Hypertension Taskforce was founded by the Australian Cardiovascular Alliance (ACvA) and Hypertension Australia, with significant support from Stroke Foundation and Heart Foundation as cofounding members. The Taskforce aims to increase the number of Australians with their blood pressure both treated and controlled effectively from 32% to 70% by 2030.

Research Found (Yet Another) Reason To Eat Dark Chocolate

 

Your competent? doctor had the hospital dietician to add this dark chocolate to your diet protocol a decade ago, right? NO? So, you DON'T have a functioning stroke doctor, do you? 

 You do have a diet protocol, don't you? Oh NO, more incompetence from your stroke medical 'professionals'! RUN AWAY!

dark chocolate (19 posts to March 2014)

Research Found (Yet Another) Reason To Eat Dark Chocolate

We know dark chocolate tends to be a healthier option compared to other sugar-packed options, but that's not the only reason to reach for a piece.

In fact, research finds that opting for this sweet treat may even have blood sugar benefits. Feast your eyes on the science below.

Dark chocolate may lower hypertension risk

A study published in Nature Scientific Reports found that dark chocolate consumption could reduce the risk of hypertension1. In addition, they suspect that dark chocolate may decrease blood clot risk, but more research is needed to establish a causal relationship for the latter. 

The team of researchers used a technique called Mendelian Randomization to analyze genetic data from genome-wide association studies. Through this method, they identified a causal relationship between dark chocolate intake and lower hypertension risk and eliminated the chance of reverse causation. 

This finding joins a long list of research-backed reasons to eat dark chocolate, like the potent antioxidant profile2, anti-inflammatory and antimicrobial3 properties, and specific benefits for fasting blood glucose levels in people with diabetes. 

Delaying onset of high blood pressure can lower stroke risk, study shows

 

I didn't get hypertension until 8 years after my stroke and that was found by my regular blood donations; one time my upper was over 180, so I couldn't donate until I got it under control.

Delaying onset of high blood pressure can lower stroke risk, study shows

Nearly half of adults in the United States have hypertension, or high blood pressure, which is the leading risk factor for stroke. While the link between hypertension and stroke risk is well studied, little is known about how long someone’s having hypertension affects these risks.

Researchers at the University of Alabama at Birmingham evaluated the association of hypertension duration on the management of hypertension and stroke risk. Results, published in the American Heart Association journal Stroke, found an increased risk of stroke and a need for more classes of antihypertension medications the longer one has high blood pressure.

The study was part of the REasons for Geographic and Racial Differences in Stroke study, a national cohort study sponsored by the National Institutes of Health.

“Treating high blood pressure is a major focus in preventing strokes. However, our study suggests we should place more emphasis on preventing high blood pressure from developing as long as possible,” said George Howard, DrPH, Distinguished Professor of Biostatistics in the UAB School of Public Health and lead author. “Data showed delaying the onset of hypertension can significantly lower one’s stroke risk and help mitigate the need for numerous medications.”

REGARDS study secures NIH funding for another five years, expands research on stroke and brain health risks.

Hypertension is defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg. The average age of hypertension onset in the United States is mid-40s. However, hypertension rates vary among sex, race and geographic location, with men, Black adults and those in the Southeastern United States, also known as the Stroke Belt, having increased risks.

The study followed 27,310 participants from the REGARDS cohort. The average age was 65 years old. Compared to participants with normal blood pressure, even given the blood pressure level and the number of medications used to control the blood pressure, the increased risk of stroke in participants with hypertension were:

Reducing salt intake can reduce blood pressure, study finds.

• 31 percent for a duration of five years or less
• 50 percent for a duration of six to 20 years
• 67 percent for a duration of over 20 years

Additionally, the data showed those who had hypertension for more than two decades were taking 2.28 classes of medications on average, compared to 1.68 classes for those who had hypertension less than five years. Secondary findings showed the average systolic blood pressure was higher in groups with longer hypertension duration. 

Learn how to identify a stroke with these signs.
Click image to enlarge.
Graphic: Jody Potter“Fortunately, there are known lifestyle interventions that can delay, and possibly prevent, the development of high blood pressure,” Howard said. “Many of these interventions are small steps individuals can implement in their daily lives.”

To lower blood pressure, and prevent hypertension, the American Heart Association recommends:

• Eating a healthy diet
• Limiting alcohol intake
• Maintaining a healthy weight
• Managing stress
• Staying physically active
• Not smoking
• Taking proper medications
• Working with a health care professional to monitor blood pressure

Nutrients deficiency pattern possible important risk factor for mortality in older adults with hypertension

 How soon before your competent? doctor tests this for you? Or do you have to train your doctor?

I have hypertension but it's treated, do I need to worry about this?

Nutrients deficiency pattern possible important risk factor for mortality in older adults with hypertension

By Dr. Priyom Bose, Ph.D.Reviewed by Benedette Cuffari, M.Sc.Jun 12 2024

A recent BMC Public Health study determines the impact of nutrient deficiencies on mortality risk in older adults with hypertension.

Study: Nutrient deficiency patterns and all-cause and cardiovascular mortality in older adults with hypertension: a latent class analysis. Image Credit: Anatoily Cherkas / Shutterstock.com

How can diet affect blood pressure?

In addition to the rapid aging of the global population, a significant increase in the prevalence of hypertension and hypertension-related mortality has been recorded. Although many effective antihypertensive medication therapies are available, millions of people continue to die from hypertension every year.

A healthy diet, in addition to medication, also helps manage hypertension. Previous epidemiological studies have highlighted that specific dietary patterns, food groups, and diet quality reduce mortality rates. These studies emphasize the importance of certain nutrients, including vitamins and minerals, in reducing the risk of mortality.

Dietary vitamins and minerals can reduce the risk of many chronic conditions and mortality. For example, one previous study indicated that an increased intake of dietary fiber reduces the mortality risk in older adults diagnosed with hypertension.

Although humans consume multiple nutrients in a single healthy meal, most studies have only assessed the efficacy of individual nutrients on mortality. Thus, there remains a need for more comprehensive research to evaluate how diverse nutrients interact with each other and affect human health and certain diseases, such as hypertension. These data will support the formulation of targeted nutrition-based interventions to minimize adverse effects in these patients.

About the study

The current study investigated how nutrient deficiency patterns, including those that affect vitamin, fiber, and mineral levels, affect morbidity and mortality in older adults with hypertension.

The latent class analysis (LCA), which is a person-centered statistical technique, was used to identify relatively similar sub-populations with similar characteristics. LCA is a widely accepted approach to formulate rational policies for managing psychology and physical diseases.

All study participants were selected from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States. Relevant data on adults 60 years of age and older with hypertension were obtained from six NHANES cycles between 2003 and 2014. Dietary data were obtained from the NHANES’s Dietary Interview-Total Nutrient Intakes section.

Study findings

Based on eligibility criteria, 6,924 individuals were selected for the study. LCA was conducted using multiple nutrients, such as fiber, folate, and vitamins A, B1, B12, C, D, E, and K, as well as minerals, including selenium, copper, iron, zinc, calcium, and magnesium.

Four distinct dietary nutrient deficiency patterns that affected older adults with hypertension were identified using LCA. These included Class 1 or Adequate Nutrient, Class 2 or Nutrient Deprived, Class 3, which reflected Low Fiber, Magnesium, and Vitamin E, and Class 4, which reflected Inadequate Nutrient. Each pattern was associated with distinct anthropogenic and demographic characteristics with differential mortality risks.

Class 1 was associated with the lowest all-cause and cardiovascular mortality rates, whereas Class 2 was associated with the highest risks. Class 3 closely resembled Class 1; however, when the levels of vitamin E, magnesium, and fiber were low, all-cause and cardiovascular mortality in this pattern were significantly higher than in Class 1.

Consuming less than 10% of the daily recommended amounts of fiber, magnesium, and vitamin E significantly increased the risk of all-cause and cardiovascular mortality among older adults with hypertension. Consistent with these findings, one previous study indicated that consuming less than 20% of recommended dietary fiber and magnesium increases mortality rates.

Completing more than a high school education was a significant protective factor of three nutrient deficiency classes. Furthermore, as compared to men, women were more likely to be nutrient deficient.

Similar to previous reports, overweight and obesity were two important deficiency classes. Ethnicity also significantly impacted nutrient deficiency classification. These differences in nutrient intake could be attributed to variations in socioeconomic status, lifestyle factors, geography, environment, and individual behaviors.

Conclusions

The current study strongly indicated that dietary deficiencies in vitamins, fiber, and minerals, particularly fiber, magnesium, and vitamin E, significantly affect all-cause and cardiovascular mortality risk among older adults with hypertension. Ethnicity, education, age, body mass index, and cardiovascular disease could serve as potential predictors of nutrient deficiency.

A key strength of the current study is the inclusion of a wide range of essential vitamins. This enabled a more accurate assessment of how nutrients and their interactions affect mortality rates in older adults with hypertension.

Taken together, older adults with hypertension could benefit from interventions targeting nutrient deficiency patterns management. Nevertheless, additional studies are needed to validate these findings.

Journal reference:

• Sun, Y., Zhang, H., Qi, G., & Tian, W. (2024) Nutrient deficiency patterns and all-cause and cardiovascular mortality in older adults with hypertension: a latent class analysis. BMC Public Health 24; 1551. doi:10.1186/s12889-024-19003-w

Dark chocolate cuts hypertension risk: Sweet news from latest study

 Which of these three is your doctor recommending? Or does your incompetent doctor not even know about them?

Then are you are using Guinness for blood thinning?

Guinness could really be good for you

Or maybe red wine for men red wine, which reduced the risk for AD only in men. Women could be more susceptible to detrimental effects of alcohol.(This won't go over well in my wine groups.)

Dark chocolate cuts hypertension risk: Sweet news from latest study

A study published in the journal Scientific Reports shows that dark chocolate intake can significantly reduce the risk of essential hypertension. Essential hypertension refers to high blood pressure that is multi-factorial and does not have a distinct cause. 

Study: Dark chocolate intake and cardiovascular diseases: a Mendelian randomization study

Background

Cardiovascular diseases are the leading cause of disability and mortality worldwide and are major contributors to the global disease burden. The estimated total number of cardiovascular disease cases was 523 million in 2019, with the Middle East and North Africa having the highest prevalence and Central Asia and Eastern Europe having the highest mortality.

Given the high morbidity and mortality associated with cardiovascular diseases, several studies have been conducted to identify both risk factors and preventive measures. Some small-scale randomized controlled trials have shown that dark chocolates benefit cardiovascular health. The main three flavanols found in dark chocolate, including procyanidin, catechin, and epicatechin are known to have beneficial effects on the cardiovascular system.  

In this study, scientists have explored the causal relationship between dark chocolate intake and cardiovascular disease risk using the Mendelian randomization method.  Mendelian randomization uses measured variation in genes of known function to examine the causal effect of a modifiable exposure on disease in observational studies.

Study design

The scientists obtained genome-wide association study summary-level data for dark chocolate intake from the MRC Integrative Epidemiology Unit (University of Bristol) website. The data included 64,945 European ancestry participants. They identified 21 independent single nucleotide polymorphisms as genetic instrumental variables for predicting dark chocolate intake. An instrumental variable is a kind of variable that is not supposed to have any direct effect on the outcome.

Furthermore, the scientists obtained summary-level data for cardiovascular diseases from various publicly available genome-wide association studies. They synchronized the datasets for dark chocolate intake and cardiovascular diseases to align the direction of alleles of the single nucleotide polymorphisms for both.      

Then, they analyzed the data to determine the causal relationship between genetically predicted dark chocolate intake and risks of 12 cardiovascular diseases, including heart failure, coronary heart disease, myocardial infarction, atrial fibrillation, non-rheumatic valve disease, non-ischemic cardiopathy, essential hypertension, venous thromboembolism, deep vein thrombosis, stroke, ischemic stroke, and transient ischemic attack. They also conducted sensitive analyses to assess the robustness of the Mendelian randomization analysis results.

Important observations

The study findings revealed that dark chocolate intake significantly reduces the risk of essential hypertension. A suggestive negative association between dark chocolate intake and the risk of venous thromboembolism was observed in the study. No significant association with dark chocolate intake was observed for other tested cardiovascular diseases.

Study significance

This study reveals that genetically predicted dark chocolate intake is significantly associated with a lower risk of essential hypertension and suggestively associated with a lower risk of venous thromboembolism.

Genetics & Genomics - Second Edition eBook NEW EDITION NOW OUT - Compilation of the top interviews, articles, and news in the last year. Download the latest edition

Available evidence indicates that flavanols present in dark chocolates can improve endothelial function, promote vasodilation, and prevent platelet aggregation by increasing nitric oxide release. Flavanols are also known to have potent antioxidant and anti-inflammatory activities. All these activities of flavanols are believed to be the main contributing factors towards a healthy cardiovascular system.

The hypertension data used in this study includes cases of secondary hypertension, which is essentially the manifestation of kidney disease, renal vascular disease, and some endocrine diseases in the cardiovascular system. However, the study does not investigate any causal relationship of these diseases with dark chocolate intake. Thus, the scientists advise that people should not rely only on dark chocolate to prevent essential hypertension. Rather, people at high risk for essential hypertension can replace unhealthy snacks with dark chocolate to improve their cardiovascular health.

As mentioned by the scientists, a small sample size of the exposure data was used in this study. The identified single nucleotide polymorphisms also failed to reach the conventional genome-wide significance threshold. However, these single nucleotide polymorphisms can be considered as effective instrumental variables as their Fisher-statistic (a measure of the ratio of variances) values are greater than 10. A Fisher-statistic value of more than 2.5 is needed to reject the null hypothesis. Moreover, the findings of sensitive analyses showed the robustness of the estimated causal effects for almost all outcomes.    

Summer-level data of European ancestry populations was used in this study. This restricts the generalizability of study findings to other populations.

Overall, the study provides valuable information for the prevention of essential hypertension in the general population. More clinical research is needed to firmly establish the causal relationship between dark chocolate intake and the risk of cardiovascular diseases.

Journal reference:

• Yang, Juntao, et al. "Dark Chocolate Intake and Cardiovascular Diseases: A Mendelian Randomization Study." Scientific Reports, vol. 14, no. 1, 2024, pp. 1-9, https://doi.org/10.1038/s41598-023-50351-6, https://www.nature.com/articles/s41598-023-50351-6

Which Interventions Could Lessen the Burden of Dementia?

With your excellent chance of dementia post stroke you'll want your doctor and hospital to ensure further research is done to get EXACT PROTOCOLS CREATED to prevent dementia. And ask for specific names who will take responsibility on getting it done.

Your risk of dementia, has your doctor told you of this?  Your doctor is responsible for preventing this!

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

The latest here:

Which Interventions Could Lessen the Burden of Dementia?

Using a microsimulation algorithm that accounts for the effect on mortality, a team from Marseille, France, has shown that interventions targeting the three main vascular risk factors for dementia — hypertension, diabetes, and physical inactivity — could significantly reduce the burden of dementia by 2040.

Among the three modifiable risk factors, the prevention of hypertension would be the most efficient, with by far the biggest impact on dementia.

Although these modeling results could appear too optimistic, since total disappearance of the risk factors was assumed, the authors say the results do show that targeted interventions for these factors could be effective in reducing the future burden of dementia.

Increasing Prevalence

According to the World Alzheimer Report 2018, 50 million people around the world were living with dementia that year; that's a community roughly around the size of South Korea or Spain. That community is likely to rise to about 152 million people by 2050, which is similar to the size of Russia or Bangladesh, the result of an aging population.

Among modifiable risk factors, many studies support a deleterious effect of hypertension, diabetes, and physical inactivity on the risk of dementia. However, since the distribution of these risk factors could have a direct impact on mortality, reducing it should increase life expectancy and the number of cases of dementia.

The team, headed by Hélène Jacqmin-Gadda, PhD, research director at the University of Bordeaux, has developed a microsimulation model capable of predicting the burden of dementia while accounting for the impact on mortality. The team used this approach to assess the impact of interventions targeting these three main risk factors on the burden of dementia in France by 2040.

Removing Risk Factors

The researchers estimated the incidence of dementia for men and women using data from the 2020 PAQUID cohort, and these data were combined with the projections forecast by the French National Institute of Statistics and Economic Studies (INSEE) to account for mortality with and without dementia.

Without intervention, the prevalence rate of dementia in 2040 would be 9.6% among men and 14% among women older than 65 years.

These figures would decrease to 6.4% (−33%) and 10.4% (−26%), respectively, under the intervention scenario whereby the three modifiable vascular risk factors (hypertension, diabetes, and physical inactivity) would be removed simultaneously beginning in 2020. The prevalence rates are significantly reduced for men and women from age 75 years. In this scenario, life expectancy without dementia would increase by 3.4 years in men and 2.6 years in women, the result of men being more exposed to these three risk factors.

Other scenarios have estimated dementia prevalence with the disappearance of just one of these risk factors. For example, the disappearance of hypertension alone from 2020 could decrease dementia prevalence by 21% in men and 16% in women (because this risk factor is less common in women than in men) by 2040. This reduction would be associated with a decrease in the lifelong probability of dementia among men and women and a gain in life expectancy without dementia of 2 years in men and 1.4 years in women.

Among the three factors, hypertension has the largest impact on dementia burden in the French population, since this is, by far, the most prevalent (69% in men and 49% in women), while intervention targeting only diabetes or physical inactivity would lead to a reduction in dementia prevalence of only 4% to 7%.

This article was translated from Univadis France, which is part of the Medscape Professional Network.

Specific Brain Damage Links Hypertension to Cognitive Impairment

Ask your doctors SPECIFICALLY  what interventions they have that will fix this cognitive impairment.  They should already have interventions to recover your

lost 5 cognitive years from your stroke  if they are competent at all.

Specific Brain Damage Links Hypertension to Cognitive Impairment

Researchers have identified specific regions of the brain that appear to be damaged by high blood pressure. The finding may explain the link between hypertension and cognitive impairment.

They used genetic information from genome-wide association studies (GWASs) and MRI scans of the brain to study the relationship between hypertension, changes in brain structures, and cognitive impairment. Using Mendelian randomization techniques, they identified nine brain structures related to cognitive impairment that are affected by blood pressure.

3D reconstruction shows how high systolic blood pressure has affected the main tracts of white matter in the brain. Red shows the areas most affected by high blood pressure. The yellow areas are also affected but to a lesser extent.

The study was published online in the European Heart Journal on March 27.

"We knew before that raised blood pressure was related to changes in the brain, but our research has narrowed down the changes to those that appear to be potentially causally related to cognitive impairment," senior author Tomasz Guzik, professor of cardiovascular medicine, at the University of Edinburgh, United Kingdom, and of the Jagiellonian University, Krakow, Poland, told theheart.org | Medscape Cardiology.

"Our study confirms a potentially causal relationship between raised blood pressure and cognitive impairment, emphasizing the importance of preventing and treating hypertension," Guzik noted.

"But it also identifies the brain culprits of this relationship," he added.

In the future, it may be possible to assess these nine brain structures in people with high blood pressure to identify those at increased risk of developing cognitive impairment, he said. "These patients may need more intensive care for their blood pressure. We can also investigate these brain structures for potential signaling pathways and molecular changes to see if we can find new targets for treatment to prevent cognitive impairment."

For this report, the investigators married together different research datasets to identify brain structures potentially responsible for the effects of blood pressure on cognitive function, using results from previous GWASs and observational data from 39,000 people in the UK Biobank registry for whom brain MRI data were available.

 

First, they mapped brain structures potentially influenced by blood pressure in midlife using MRI scans from people in the UK Biobank registry. Then they examined the relationship between blood pressure and cognitive function in the UK Biobank registry. Next, of the brain structures affected by blood pressure, they identified those that are causally linked to cognitive impairment.

This was possible thanks to genetic markers coding for increased blood pressure, brain structure imaging phenotypes, and those coding for cognitive impairment that could be used in Mendelian randomization studies.

"We looked at 3935 brain magnetic resonance imaging–derived phenotypes in the brain and cognitive function defined by fluid intelligence score to identify genetically predicted causal relationships," Guzik said.

They identified 200 brain structures that were causally affected by systolic blood pressure. Of these, nine were also causally related to cognitive impairment. The results were validated in a second prospective cohort of patients with hypertension.

"Some of these structures, including putamen and the white matter regions spanning between the anterior corona radiata, anterior thalamic radiation, and anterior limb of the internal capsule, may represent the target brain regions at which systolic blood pressure acts on cognitive function," the authors comment.

In an accompanying editorial, Ernesto Schiffrin, MD, and James Engert, PhD, McGill University, Montreal, Canada, say that further mechanistic studies of the effects of blood pressure on cognitive function are required to determine precise causal pathways and the roles of relevant brain regions.

"Eventually, biomarkers could be developed to inform antihypertensive trials. Whether clinical trials targeting the specific brain structures will be feasible or if specific antihypertensives could be found that target specific structures remains to be demonstrated," they write.

"Thus, these new studies could lead to an understanding of the signaling pathways that explain how these structures relate vascular damage to cognitive impairment in hypertension, and contribute to the development of novel interventions to more successfully address the scourge of cognitive decline and dementia in the future," the editorialists conclude.

The study was funded by the European Research Council, the British Heart Foundation, and the Italian Ministry of Health.

European Heart Journal. Published online March 27, 2023. Full text, Editorial

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COVID-19 is associated with higher diabetes and hypertension risk

You are already at risk for Parkinsons due to your stroke so make sure your doctor prevents diabetes.

Parkinson’s Disease May Have Link to Stroke March 2017 

The latest here:

Convincing evidence that type 2 diabetes is associated with increased risk of Parkinson's

Get vaccinated.

COVID-19 is associated with higher diabetes and hypertension risk

In a recent study published in the journal JAMA Network Open, researchers determined new-onset diabetes, hypertension, and hyperlipidemia, all cardiometabolic disorders in adult coronavirus disease 2019 (COVID-19) patients under treatment in California, United States of America (USA) between March 2020 and June 2022.

They used a self-constrained exposure-crossover design to estimate the odds of a new-onset cardiometabolic disorder occurring 90 days after or before COVID-19.

Research Letter: Association of COVID-19 Vaccination With Risk for Incident Diabetes After COVID-19 Infection. Image Credit: piccreative / Shutterstock

Background

The risk of developing cardiometabolic diseases was highest early on in the COVID-19 pandemic. However, studies have not yet explored whether this risk persists during the predominance era of less virulent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant. It also remains unclear if these risks have become attenuated due to COVID-19 vaccination.

About the study

In the present study, researchers identified newly reported cardiometabolic diagnoses after or before a patient’s first COVID-19 episode. The study population comprised a cohort of patients who had COVID-19 once or more and sought treatment at the Cedars-Sinai Health System in Los Angeles, USA.

They considered all time-varying confounders arising from disturbances in healthcare use during the pandemic when estimating the likelihood of a new onset of a cardiometabolic disorder. So, they compared their findings with new-onset benchmark diagnoses, e.g., urinary tract infection, representing a marker of COVID-19-unrelated healthcare use.

The team used a multivariable logistic regression model to estimate the odds ratio (OR) and 95% confidence interval (CI) for a new-onset cardiometabolic vs. new-onset benchmark diagnosis. The study OR estimates spanned 90 days after and before the SARS-CoV-2 infection, and the study model adjusted for age, gender, infection time (pre- and post-Omicron), and SARS-CoV-2 vaccination status of each participant.

Results & conclusion

In the current cohort study, the researchers analyzed 23,709 patients with an average age of 47.4 years who experienced one or more episodes of COVID-19. There were 12,706 females, 10,981 males, and 22 people with unknown gender, respectively.

The study results were consistent with the findings of another recent meta-analysis. They confirmed that SARS-CoV-2 infection increased the risk of new-onset diabetes and other cardiometabolic diseases. Accordingly, the incidence rate of these diseases was higher in the test group 90 days after SARS-CoV-2 infection vs. before infection, with an adjusted multivariable model showing an OR equal to 1.58 and 95% CI. Also, the odds were the highest for diabetes, followed by hypertension.

Intriguingly, COVID-19 increased the odds of benchmark diagnoses more than hyperlipidemia and hypertension. Furthermore, the interaction between vaccination status and new-onset diabetes was statistically insignificant, with OR=0.59, 95%CI. Nevertheless, the risk of diabetes was higher among unvaccinated than vaccinated people (ORs 1.78 vs.1.07; 95% CI), suggesting COVID-19 vaccination was beneficial. Sociodemographic factors, such as age, gender, and preexisting cardiovascular conditions, also had no apparent interaction with new-onset cardiometabolic diagnosis before or after SARS-CoV-2 infection in any model.

Even after accounting for time-varying confounders, the risk of new-onset cardiometabolic diagnosis persisted during the Omicron predominance period. To conclude, studies have not clarified mechanisms contributing to post-SARS-CoV-2-infection diabetes risk. However, some researchers have proposed that persistent inflammation contributes to insulin resistance magnifying the risk of diabetes.

Thus, there is an urgent need for further studies exploring the sequelae of COVID-19 and how COVID-19 vaccination might reduce the risk of new-onset cardiometabolic diseases.

Journal reference:

• Kwan AC, Ebinger JE, Botting P, Navarrette J, Claggett B, Cheng S. Association of COVID-19 Vaccination With Risk for Incident Diabetes After COVID-19 Infection. JAMA Netw Open. 2023. DOI: 10.1001/jamanetworkopen.2022.55965, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801415

Gluconic acid level may predict hypertension, stroke in Black adults

Ask your doctor if this testing is part of their protocols on stroke.

Gluconic acid level may predict hypertension, stroke in Black adults

Elevated gluconic acid, a plasma metabolite, could be a potential race-specific indicator of hypertension and ischemic stroke among Black adults, according to a study presented at the International Stroke Conference.

Lifestyle factors associated with elevated gluconic acid among Black adults included Southern diet, lower educational attainment and lack of exercise, a speaker reported.

Elevated gluconic acid could be a potential race-specific indicator of hypertension and ischemic stroke among Black adults.
Data were derived from Kijpaisalratana N, et al. Abstract 83. Presented at: International Stroke Conference; Feb. 8-10, 2023; Dallas (hybrid meeting).

“We have identified a biomarker called gluconic acid that we believe is a lifestyle-related biomarker, providing a direct link to diet and exercise,” Naruchorn Kijpaisalratana, MD, PhD, research fellow in neurology at Massachusetts General Hospital, said in a press release. “Gluconic acid may be considered as a dietary-related oxidative stress marker due to its availability in food, potentially produced by the gut microbiome, and related to diseases with oxidative stress. We think that this biomarker may provide a pathway to improve diet and exercise habits to help prevent a future stroke.”

The present analysis was a case-cohort evaluation of participants in the REGARDS study, which included 30,239 Black and white participants aged 45 years and older. Kijpaisalratana and colleagues compared metabolites measured by liquid chromatography-tandem mass spectrometry in 1,075 patients with ischemic stroke with those of a random cohort of 968 REGARDS participants.

The researchers utilized weighted logistic regression and Cox proportional hazard models to identify race-specific metabolites associated with hypertension and incident stroke and assessed mediation between the two.

The researchers quantified a total of 162 plasma metabolites, and, of these, gluconic acid was associated hypertension in Black adults (OR = 1.86; 95% CI, 1.39-2.47; P < .0001) but not white adults (OR = 1; 95% CI, 0.8-1.24; P = .97; P for interaction < .001).

Gluconic acid was also associated with risk for incident ischemic stroke among Black (HR = 1.53; 95% CI, 1.28-1.81; P < .0001) but not white adults (HR = 1.16; 95% CI, 1-1.34; P = .057; P for interaction = .019).

Moreover, gluconic acid mediated around one-fourth of the association between hypertension and ischemic stroke among Black adults (25.4%; 95% CI, 4.1-46.8; P = .02), according to the study.

After multivariable analyses, Kijpaisalratana and colleagues determined that lifestyle factors associated with increased gluconic acid in Black adults included Southern diet (beta = 0.18; 95% CI, 0.08-0.28; P < .001), lower educational attainment (beta = 0.45; 95% CI, 0.19-0.72; P = .001) and lack of exercise (beta = 0.26; 95% CI, 0.01-0.51; P = .045).

“In the future, we envision that a metabolite-like gluconic acid may be used as a biomarker to inform health care professionals whether the patient is eating healthy enough or exercising enough,” Kijpaisalratana said in the release. “A biomarker like gluconic acid may point individuals toward more targeted guidance for stroke prevention.”

Reference:

• Lifestyle biomarker linked to high blood pressure, increased stroke risk among Black adults. newsroom.heart.org/news/lifestyle-biomarker-linked-to-high-blood-pressure-increased-stroke-risk-among-black-adults. Published Feb. 2, 2023. Accessed Feb. 7, 2023.

Heavy coffee drinking may double risk for CV death in hypertension

 You don't say whether this is after treatment by blood pressure meds or not, so to me completely useless. My blood pressure while treated is 134/84. This will not change my coffee consumption at all. 10-12 cups a day, no jitteriness ever, I assume I'm in the small percentage that processes caffeine quickly. 

Well, yeah I'm using coffee to prevent dementia and Parkinsons, but since research doesn't say how much, I'm doing up to 12 cups a day to not fall below the threshold needed.

How coffee protects against Parkinson’s Aug. 2014  

Coffee May Lower Your Risk of Dementia Feb. 2013 

And this: Coffee's Phenylindanes Fight Alzheimer's Plaque December 2018

The latest here:

Heavy coffee drinking may double risk for CV death in hypertension

Among adults with hypertension followed for nearly 2 decades, heavy coffee drinking was associated with doubled risk for CV death compared with no coffee drinking, according to data from a large observational study.

In contrast, green tea consumption was not associated with increased risk for CVD mortality across all BP categories.

Among adults with hypertension followed for nearly 2 decades, heavy coffee drinking was associated with doubled risk for CV death compared with no coffee drinking.
Source: Adobe Stock

“Our study aimed to determine whether the known protective effect of coffee also applies to individuals with different degrees of hypertension and also examined the effects of green tea in the same population,” Hiroyasu Iso, MD, PhD, MPH, director of the Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine in Tokyo and professor emeritus at Osaka University, said in a press release. “This is the first study to find an association between drinking two or more cups of coffee daily and CVD mortality among people with severe hypertension.”

Iso and colleagues analyzed data from 18,609 participants in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk, including 12,035 women, who were aged 40 to 79 years at baseline and completed a lifestyle, diet and medical history questionnaire and submitted to regular health exams. Researchers asked participants about their frequency and amount of coffee and green tea consumed using the following choices: almost every day; three to four cups per week; one to two cups per week; one to two cups per month; and almost never. Participants who answered “almost every day” were asked about the number of cups consumed per day. Researchers followed the cohort through 2009 and classified participants into four BP categories: optimal and normal BP (systolic BP < 130 mm Hg and diastolic BP < 85 mm Hg), high-normal BP (systolic BP 130-139 mm Hg or diastolic BP 85-89 mm Hg), grade 1 hypertension (systolic BP 140-159 mm Hg and diastolic BP 90-99 mm Hg), and grade 2 to 3 hypertension (systolic BP 160 mm Hg and diastolic BP 100 mm Hg).

During a median of 18.9 years follow-up, 842 participants died of CV causes.

Researchers found that heavy coffee consumption was associated with increased risk for CVD mortality among people with grade 2 to 3 hypertension. Compared with noncoffee drinkers, HRs for CVD mortality were 0.98 (95% CI, 0.67-1.43) for less than one cup per day, 0.74 (95% CI, 0.37-1.46) for one cup per day and 2.05 (95% CI, 1.17-3.59) for two or more cups per day.

There were no associations between coffee consumption and CV death for people with optimal and normal, high-normal BP and grade 1 hypertension.

Green tea consumption was not associated with an increased risk for CVD across any BP categories, according to researchers.

“These findings may support the assertion that people with severe high BP should avoid drinking excessive coffee,” Iso said in the release. “Because people with severe hypertension are more susceptible to the effects of caffeine, caffeine’s harmful effects may outweigh its protective effects and may increase the risk of death.”

The study found that people with more frequent coffee consumption were more likely to be younger, to be current smokers, to be current drinkers, to eat fewer vegetables, and to have higher total cholesterol levels and lower systolic BP, regardless of BP category.