Deans' stroke musings: Severe Stroke: These Are the 3 Cardiovascular Factors That May Up Risk

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.

Thursday, January 16, 2025

Severe Stroke: These Are the 3 Cardiovascular Factors That May Up Risk

Is your competent? doctor up to the task of creating a diet protocol and getting you 100% recovered to do all the physical activity you want to? I highly doubt it.

Severe Stroke: These Are the 3 Cardiovascular Factors That May Up Risk

Diabetes, diet quality, and physical inactivity were associated with a higher risk for stroke.

Hypertension, atrial fibrillation (AF), and smoking are predictors of severe stroke, while a higher waist-to-hip ratio increases risk for nonsevere stroke. These are the findings of a study published in Neurology.

Previously, the modifiable risk factors associated with stroke were determined in the INTERSTROKE study. To inform public health strategies in stroke prevention, researchers assessed whether the magnitude of traditional risk factors differed by stroke severity.

Participants in the INTERSTROKE study between 2007 and 2015 were included in the current analysis. Eligible participants presented with their first case of ischemic or hemorrhagic stroke and were enrolled within 72 hours of hospitalization or 5 days of symptom onset. A control group of individuals without stroke were also included for comparison.

The modified Rankin Scale (mRS) score was used to measure stroke severity on a scale from 0 to 6, with 0 indicating no symptoms and 6 indicating death. In addition, data on demographics, lifestyle factors, physical measurements, such as waist-to-hip ratio, levels of stress, and the presence of any depressive symptoms, were all collected from participants using standardized questionnaires.

Our results support efforts to control hypertension, atrial fibrillation, and smoking to prevent severe, disabling stroke.

A total of 26,948 participants (13,460 with stroke and 13,488 control) were included in the analysis. Mean age of the total cohort was 61.74 years; 59.5% were men. Of those with stroke, 4848 (36%) had severe stroke (mRS, 4-6) and 8612 (64%) had nonsevere stroke (mRS, 0-3).

Individuals with severe vs nonsevere stroke were older, more commonly had intracerebral hemorrhage (ICH) and a history of hypertension, AF, and diabetes. Patients with severe stroke were most often from South Asia, while those with nonsevere stroke were most often from China.

The researchers found that patients with both severe and nonsevere stroke had a higher risk for hypertension, with a significantly increased risk with severe vs nonsevere stroke (severe stroke: odds ratio [OR], 3.21; 95% CI, 2.97-3.47; nonsevere stroke: OR, 2.87; 95% CI, 2.69-3.05; P_{heterogeneity} =.03 and P_case-case <.001).

While AF was associated with stroke, the risk for AF was also higher among patients with severe vs nonsevere stroke (severe stroke: OR, 4.70; 95% CI, 4.05-5.45; nonsevere stroke: OR, 3.61; 95% CI, 3.16-4.13; P_{heterogeneity} =.009; P_case-case<.001).

Smoking was also associated with increased risk for both severe and nonsevere stroke, with severe vs nonsevere stroke resulting in a greater risk (severe stroke: OR, 1.87; 95% CI, 1.72-2.03; nonsevere stroke: OR, 1.65; 95% CI, 1.54-1.77; P_{heterogeneity} =.02; P_case-case<.001).

There were no significant differences between the severe and nonsevere stroke groups in terms of diabetes, diet quality, physical inactivity, stress, alcohol use, and levels of apolipoprotein (Apo).

While higher waist-to-hip ratio was found to be associated with both severities of stroke, patients with severe vs nonsevere stroke had a lesser risk (severe stroke: OR, 1.11; 95% CI, 1.02-1.20; nonsevere stroke: OR, 1.37; 95% CI, 1.28-1.47; P_{heterogeneity} <.001; P_case-case<.001).

Limitations of the analysis included the possibility of unmeasured confounders and that the mRS score may have underestimated stroke severity. “Our results support efforts to control hypertension, atrial fibrillation, and smoking to prevent severe, disabling stroke,” the researchers concluded.