Spain’s Cardiovascular Risk Standards Introduce Vascular Age

 See if you have an incompetent doctor, one who knows nothing about this because s/he doesn't follow research! And then fire your board of directors since they don't know how to run a stroke hospital!

Determinants of Vascular Age: An Epidemiological Perspective January 2019

Arterial stiffness (32 posts to December 2014) The latest here:

Spain’s Cardiovascular Risk Standards Introduce Vascular Age

Cardiovascular disease (CV) remains the leading cause of death in Spain, contributing to disability and healthcare costs. The Spanish Society of Arteriosclerosis released the 2026 edition of its standards for global CV risk control, which is an updated clinical reference designed to guide prevention, diagnosis, and management.

The document, updated every 2 years, combines current evidence and incorporates recent advances in CV research and clinical practice. One of the most notable changes in the 2026 update is the replacement of the traditional concept of CV risk with the concept of vascular age, which is presented in a newly updated risk table intended to improve communication with patients.

These standards were first introduced in 2020 and have become important references for clinicians involved in vascular risk management.

More than 30 professionals from multiple specialties contributed to the latest update, including experts in internal medicine, endocrinology, primary care, clinical laboratory medicine, and cardiology.

Comprehensive Risk Assessment

Because atherosclerosis has a multifactorial origin, standards emphasize a comprehensive approach to CV risk assessment.

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This document reviews the full clinical pathway for patients with vascular disease, including the initial evaluation and diagnostic testing, criteria for diagnosis, methods for estimating vascular risk, recommendations for both lifestyle and pharmacologic management, and criteria for referral and discharge.

It also proposes organizational recommendations for dedicated vascular risk clinics to offer practical guidance to healthcare professionals in managing these patients in daily clinical practice.

Role of Family History

These standards highlight the importance of obtaining detailed family histories of first-degree relatives when evaluating CV risk.

This is particularly relevant for conditions linked to atherosclerotic vascular disease and major CV risk factors, such as suspected familial hypercholesterolemia or premature vascular disease.

Family history was more significant when events occurred at younger ages (< 55 years in men and < 65 years in women).

In addition to general medical history, such as allergies or earlier surgical procedures, clinicians are recommended to investigate the history of atherosclerotic vascular disease and major risk factors, including diabetes, hypertension, dyslipidemia, smoking, and obesity.

When present, the age of onset and details of current or earlier treatments should be recorded, regardless of their indication.

Diagnostic Evaluation

According to a consensus document developed by 15 Spanish scientific societies, the evaluation should include a basic lipid profile.

Clinicians should also conduct a targeted smoking history test, including the Fagerström test, to assess nicotine dependence in individuals who smoke.

Diagnostic evaluations may also include additional tests tailored to individual patient profiles.

For individuals without proven atherosclerotic vascular disease but with CV risk factors, calculating vascular risk is a key step. This estimation informs major clinical decisions, such as when to initiate lipid-lowering therapy and what treatment targets should be pursued.

Imaging for Subclinical Disease

José María Mostaza, MD, PhD, from the Hospital Carlos III, Madrid, Spain, and the first author of the document, noted that the section on imaging for subclinical CV disease has been substantially expanded.

The updated guidelines clarify how carotid ultrasound, femoral ultrasound, and coronary artery calcium scoring can improve CV risk estimation.

These imaging approaches may help detect early vascular changes before the development of a clinical disease.

Key Innovations in the 2026 Edition

Another new feature of the 2026 standards is the introduction of an updated table on vascular age.

Clinicians can estimate the age of a patient’s arteries based on their risk profiles instead of communicating abstract risk percentages.

According to Mostaza, many patients find CV risk percentages difficult to understand. Telling a 50-year-old patient that their arteries resemble those of a 70-year-old often makes the message clearer.

The new edition also incorporates updated recommendations from the Spanish Society of Arteriosclerosis on diet and CV prevention, as well as clinical practice recommendations derived from the society’s consensus on lipoprotein(a).

In addition, the standards integrate guidance from various international and national guidelines published in the past 2 years. These include the 2025 European update on dyslipidemia, American guidelines on hypertension, Spanish guidelines on obesity, the American Diabetes Association standards, Canadian guidelines on tobacco cessation, and European guidelines on atrial fibrillation.

Ferrer, part of Grupo Ferrer Internacional SA, provided support for the publication and administrative support for updating the Spanish Society of Arteriosclerosis 2026. However, the company had no role in drafting or deciding the content of the document.

This story was translated from El Medico Interactivo, part of the Medscape Professional Network.

Wine as Food and Medicine

22 pages, but I'm only interested in saponins.  While you can just as easily get resveratrol from grape juice, what is the fun in that? So those excessive alcohol delivery systems of red wine from Oregon and California producers actually do some good.  This doesn't mean you can drink red wine to excess as a healthy tonic, although this Spanish gentleman did:

Man Dies Aged 107, Thanked Red Wine For Long Life - 3 liters a day, no water

But your doctor will use this to tell you no alcohol:

Safest level of alcohol consumption is none, worldwide study shows

 

How did listening to your doctor get you anywhere close to 100% recovery? But since I'm not medically trained, whatever I say has no validity.  But I'm using this:  Smarter People Tend To Drink More Alcohol.

Wine as Food and Medicine

Further phytonutrient in grape with health benefits are saponins which reduce blood cholesterol by binding its molecules and preventing their absorption, as well as reducing inflammation and cancer-protecting effect. Scientists from the University of California found that alcohol improve the bioavailability of saponins that means making them more easily absorbed in wine. The content of saponins in red wines is 3 to 10 times higher than the amount of saponins contained in white wines. Besides there is a positive association between the alcohol concentration and saponin concentration; that means stronger wines having more saponins. The highest content of saponins was found in red Zinfandel (16% alcohol) followed by Syrah, Pinot noir and Cabernet Sauvignon. White varieties like Sauvignon blanc and Chardonnay contain much less saponins. Furthermore Grape berries contain Pterostilbene with antioxidant activity which has also positive effects against cancer and cholesterol.

One-handed map challenges

I'm going to Spain for two weeks in March, 5 days in Madrid, 9 days traveling the country by car, possibly take a ferry and stay the night in Tangiers. So I bought a Marco Polo Spain/Portugal map.  It folds out and folds out even more, keeping it flat on my desk in the office is almost impossible one handed. It is going to be a real challenge to use in the car. And if I have to look at the backside of the map because we go to the left side of Spain I'm going to rip it into pieces. Another missed ADL training from my therapists.  I will get international data roaming so I can use GPS on my phone, That is compensation which I swore I would never do.

Evaluation of patient satisfaction after stroke rehabilitation program. Validation study for the Spanish version of the Satisfaction Pound Scale

I bet this is totally bogus because the staff is influencing the answers. They are saying you recovered well, not even acknowledging that 100% recovery was the goal. And meeting that goal for the hospital is a complete failure.
http://www.sciencedirect.com/science/article/pii/S2387020616307057

Evaluación de la satisfacción con el programa de rehabilitación tras el ictus: validación de la versión española de la Pound Satisfaction Scale ^☆

• Aizpea Aguirrezabal Juaristi^{a, ,} ,
• Montse Ferrer Fores^b,
• Ester Marco Navarro^a,
• Sergi Mojal García^b,
• Gemma Vilagut Saiz^b,
• Esther Duarte Oller^a

 Show more

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http://dx.doi.org/10.1016/j.medcle.2016.12.003

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Refers To

• Aizpea Aguirrezabal Juaristi, Montse Ferrer Fores, Ester Marco Navarro, Sergi Mojal García, Gemma Vilagut Saiz, Esther Duarte Oller

• Evaluación de la satisfacción con el programa de rehabilitación tras el ictus: validación de la versión española de la Pound Satisfaction Scale

• Medicina Clínica, Volume 147, Issue 10, 18 November 2016, Pages 441-443
• •  Purchase PDF - $35.95

CB1 and CB2 Cannabinoid Receptor Antagonists Prevent Minocycline-Induced Neuroprotection Following Traumatic Brain Injury in Mice

It should not be called neuroprotection, it is stopping the neuronal cascade of death. Bet this never gets approved for stroke survivors in the USA. It is better to let survivors stay disabled rather than allow 'Reefer Madness' to take place in our elderly population. 

CB1 and CB2 Cannabinoid Receptor Antagonists Prevent Minocycline-Induced Neuroprotection Following Traumatic Brain Injury in Mice

1. Ana Belen Lopez-Rodriguez1,5,
2. Eleni Siopi2,
3. David P. Finn4,
4. Catherine Marchand-Leroux2,
5. Luis M. Garcia-Segura5,
6. Mehrnaz Jafarian-Tehrani2,3 and
7. Maria-Paz Viveros1⇑

+ Author Affiliations

1. ¹Faculty of Biology, Department of Animal Physiology (Animal Physiology II), Complutense University of Madrid—Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain,
2. ²Faculté des Sciences Pharmaceutiques et Biologiques, Laboratoire de Pharmacologie de la Circulation Cérébrale (EA4475),
3. ³CNRS UMR 8194, UFR Biomédicale des Saints-Pères, Université Paris Descartes, Sorbonne Paris Cité, Paris, France,
4. ⁴Pharmacology and Therapeutics, School of Medicine, NCBES Neuroscience Cluster and Centre for Pain Research, National University of Ireland Galway, Galway, Ireland
5. ⁵Instituto Cajal, Consejo Superior de Investigaciones Cientificas (CSIC), Madrid, Spain

1. Address correspondence to Maria-Paz Viveros, Department of Animal Physiology (Animal Physiology II), Faculty of Biology, Complutense University of Madrid, Calle Jose Antonio Novais 2, Madrid 28040, Spain. Email: pazviver@bio.ucm.es

Abstract

Traumatic brain injury (TBI) and its consequences represent one of the leading causes of death in young adults. This lesion mediates glial activation and the release of harmful molecules and causes brain edema, axonal injury, and functional impairment. Since glial activation plays a key role in the development of this damage, it seems that controlling it could be beneficial and could lead to neuroprotective effects. Recent studies show that minocycline suppresses microglial activation, reduces the lesion volume, and decreases TBI-induced locomotor hyperactivity up to 3 months. The endocannabinoid system (ECS) plays an important role in reparative mechanisms and inflammation under pathological situations by controlling some mechanisms that are shared with minocycline pathways. We hypothesized that the ECS could be involved in the neuroprotective effects of minocycline. To address this hypothesis, we used a murine TBI model in combination with selective CB1 and CB2 receptor antagonists (AM251 and AM630, respectively). The results provided the first evidence for the involvement of ECS in the neuroprotective action of minocycline on brain edema, neurological impairment, diffuse axonal injury, and microglial activation, since all these effects were prevented by the CB1 and CB2 receptor antagonists.

Extra virgin olive oil is the best option for frying fish

But coconut oil was not tested, so this research pretty much tells us nothing. Spain happens to be the largest producer of olive oil, so I suspect bias here.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=166183&CultureCode=en
Researchers at the UPV/EHU-University of the Basque Country have studied the changes that take place in fish lipids and in the oil during frying processes
The frying techniques, the nature of the oil used and the fish species have been shown to exert a great influence on the changes that take place during the process. UPV/EHU researchers have shown that the choice of cooking oil is hugely important owing to its impact on the lipid profile in the fish and on the possible generation of toxic compounds in the oil during frying, which can influence food safety and human health.
The journal Food Research International has published the article ‘The influence of frying technique, cooking oil and fish species on the changes occurring in fish lipids and oil during shallow-frying, studied by H-1 NMR’, which deals with the work carried out by Bárbara Nieva-Echevarría, Encarnación Goicoechea, María José Manzanos and María Dolores Guillén. To conduct this research, fillets of European seabass (Dicentrarchus labrax) and gilthead seabream (Sparus aurata) were shallow-fried in a frying plan and in a microwave oven using extra virgin olive oil and refined sunflower oil. The changes that took place in the lipid composition of the fish and of the frying oil were studied by means of Proton Nuclear Magnetic Resonance Imaging (H-1 NMR).
Migration of lipid components between the fish and the frying oil
During the shallow-frying of the fish under domestic conditions, not only do the fish lipids migrate to the frying oil, the components of the oil are also transferred to the fillet of fish. As a result, the composition of the oil used for frying is modified: firstly, it is enriched by the acyl groups (‘fatty acids’) that are present in a higher concentration in the fish fat than in the original oil, and secondly, and simultaneously, it is depleted in the acyl groups present in a higher concentration in the original oil than in the fish fat. So after having been used for frying, the extra virgin olive oil was richer in omega-3, omega-1 acyl groups, linoleic and saturated fats (from the fish) and poorer in oleic, which is the main acyl group in olive oil. Likewise, after having been used for frying, the sunflower oil was richer in all the acyl group types (coming from the fish) except linoleic, which is the majority acyl group in sunflower oil. Furthermore, after frying, both types of oil were enriched by small amounts of cholesterol (from the fish).
As regards the fat in the fish fillets, its composition also changed during the frying process, and became enriched by the acyl groups present in a higher concentration in the frying oil than in the fillet (in other words, oleic if extra virgin olive oil was used, or linoleic if sunflower oil was used) and in plant sterols. Simultaneously, during the frying process the lipids in the fish fillets were depleted in the acyl groups and minority components present in a greater concentration in the raw fillet than in the original oils, such as, for example, the omega-3 docosahexaenoic (DHA) and eicosapentaenoic (EPA) polyunsaturated groups.
Thermal oxidation reaction
Besides the migration of lipids during frying, because these oils are subjected to high temperatures (170 ºC) in the presence of oxygen, certain small-scale thermal oxidation may take place in them. In the extra virgin olive oil used for frying fish, this thermal oxidation reaction did not occur as it is more degradation-resistant than sunflower oil. Yet in the sunflower oil used for frying fish in the frying pan, secondary oxidation compounds (aldehydes) were formed; some of them are regarded as potentially toxic depending on the concentration in which they are found. It should be pointed out that these compounds did not form in the sunflower oil used to fry the fish in the microwave oven. Therefore, in view of the results obtained and bearing in mind the generation of these compounds that are potentially harmful for health, the healthiest option for frying is to use extra virgin olive and fry in the microwave.
Fat content of the fried fish
The fish species used was also seen to be a factor that considerably influences the fat absorption-desorption process during frying. The fat content of the gilthead seabream had diminished after frying while that of the European seabass remained similar or increased with respect to the starting level.
This study shows that the frying technique, the type of oil used and the fish species exert a great influence on the changes that take place during the frying process. Correctly selecting the oil is of paramount importance owing to its impact on the final composition of the fat in the cooked fillet and the possible generation of potentially toxic compounds in the oil during the frying process, which will greatly influence food safety and human health.

• Full bibliographic informationNieva-Echevarria, B., Goicoechea, E., Manzanos, MJ. & Guillen, MD. ‘The influence of frying technique, cooking oil and fish species on the changes occurring in fish lipids and oil during shallow-frying, studied by H-1 NMR’. Food Research International. Volume 84, June 2016, Pages 150–159. doi: 10.1016/j.foodres.2016.03.033

Man Dies Aged 107, Thanked Red Wine For Long Life - 3 liters a day, no water

I know I shouldn't write about anecdotal data but this is too good to pass up. I bet you will never be able to drink red wine in the hospital.
http://news.yahoo.com/man-dies-aged-107-thanked-red-wine-for-long-life-103424070.html

Red wine has been credited with everything from preventing cancer to halting weight gain.

Now comes the news that a recently deceased man believed it helped him reach the age of 107.

Spaniard Antonio Docampo Garcia died last week after many years of refusing to drink water, preferring to guzzle his home-made red wine instead.

Antonio, of Vigo, north-western Spain, told friends and family that red wine was the secret to his long life.

While there is evidence to suggest that red wine can be good for our health, medics usually recommend a glass or two a day - whereas Antonio regularly drank three litres. 

.

According to Antonio’s son, Manuel Docampo Lopez, his dad usually drank a litre-and-a-half at lunchtime, and the same again at dinner. 

“I would watch him drink a litre-and-a-half all at once, and he never drank water,” Manuel said.

He added that he was also a fan of his father’s home-made red wine, and together they could get through more than 200 litres a month.

After fighting in the Spanish Civil War and coming close to death, Antonio retired from the army to become a wine grower.
He dedicated the rest of his life to making wine, founding the company Bodegas Docampo.
While the majority of the wine produced was sold, Docampo made sure to keep a considerable amount for his own private consumption.

“If he produced 60,000 litres a year he would keep 3,000 litres for himself,” his nephew, Jeronimo Docampo, who now runs Bodegas Docampo, told local media.

As for those who told him to drink less, Antonio would say: “Give me another glass of wine so I can snore when I’m dead.”

We’ll drink to that.

Uric Acid Boosts 'Clot-Busting' Therapy for Stroke

How hard will it be for this research from Spain to be implemented in the US? I'm guessing 50 years so US survivors will be fucked over for that long because no one is implementing research into clinical applications.
http://www.medpagetoday.com/Cardiology/Strokes/52559?xid=nl_mpt_DHE_2015-07-13&eun=g424561d0r
Giving uric acid (UA) with intravenous thrombolytic therapy to patients with acute ischemic stroke could help improve 90-day outcomes, particularly in women, Spanish researchers have found.
Reanalyzing results of the Efficacy Study of Combined Treatment With Uric Acid and rtPA in Acute Ischemic Stroke (URICO-ICTUS) trial -- - a 10-center study in which 411 stroke patients were treated with alteplase and either 1,000 mg of UA or placebo within 4.5 hours of symptom onset -- - researchers found that 47 of 111 (42%) women treated with UA, and 28 of 95 (29%) women treated with placebo, achieved an excellent outcome at 90 days.

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Excellent outcome was defined as a modified Rankin Scale (mRS) of 0 to 1, in patients with a premorbid mRS score <2, or an mRS of 2, in patients with a premorbid mRS score equal to 2. By comparison, 36 of 100 (36%) men treated with UA and 38 of 105 (34%) men treated with placebo achieved excellent outcome.
"UA therapy doubled the effect of placebo to attain an excellent outcome in women (OR 2.088; 95% C.I. 1.050-4.150; P=0.036) but not in men (OR 0.999; 95% C.I. 0.516-1.934; P=0.997)," wrote Laura Llull, MD, of the University of Barcelona, Spain, and colleagues in the journal Stroke. In addition, interactions between treatment and serum UA levels (P<0.001) or allantoin/UA ratio (P<0.001) on infarct growth were found to be significant only in women, they said.
During the URICO-ICTUS study, patients had a non-contrast CT at baseline and at 36 hours were admitted to stroke-dedicated hospital units. Vital signs and blood pressure were monitored for at least 24 hours; neurological status was assessed using the NIH Stroke Scale (NIHSS) every four to eight hours during hospitalizations; functional outcome was assessed with the mRS at 90 days by certified stroke neurologists.
Multimodal brain imaging was performed in 46 participants, of whom blood samples were collected in 43. Infarct growth was defined as the difference between 72-hour diffusion-weighted imaging infarct volume and baseline nonviable tissue volume on CT perfusion. Serum UA and allantoin were measured in blood samples collected before treatment onset, at 6 to 12 hours, at 48 hours, and at 90 days. The AL/UA ratio and the percent change of serum UA from baseline values also were calculated.
During the reanalysis, researchers divided patient records by gender, and compared baseline demographic features, risk factors, baseline biological findings, stroke subtypes, neurological course and radiological findings between the two groups.

The 206 women and 205 men had significant differences in demographics, risk factors, stroke subtypes and clinical severity at baseline, the authors found. The interaction between treatment (UA or placebo) and gender had a significant effect on the rate of excellent outcome (P=0.045), indicating that the effect of therapy on outcome differed by gender. Statistical analyses found that UA therapy was more effective than placebo in women but not men, and that the NIHSS score at study onset was the only additional independent factor associated with excellent outcome at 90 days in both women (OR 0.844; 95% C.I. 0.790-0.902; P<0.001) and men (OR 0.821; [95% CI 0.762 - 0.866] P <0.001).
UA and allantoin were highly correlated in baseline serum, at 6 to 12 hours, at 48 hours and at 90 days, they found. Treatment and gender had a significant interaction with UA levels at 6 to 12 hours, with serum allantoin at 6 to 12 hours and at 48 hours, and with the AL/UA ratio at 6 to 12 hours and at 48 hours. In untreated patients, serum UA declined at 6 to 12 hours, 48 hours and 90 days after stroke onset, and the serum UA levels were lower in women than in men. After UA therapy, both genders had increased serum UA levels at 6 to 12 hours. Serum allantoin did not change over time in the placebo group; women had lower levels than men at 6 to 12 hours and 48 hours, but not at 90 days. Both genders showed a significant rise in allantoin levels at 6 to 12 hours, 48 hours and at 90 days of UA therapy.
The interaction between treatment and gender with regard to infarct growth was not significant (P=0.973) but UA therapy was found to be better than placebo in reducing infarct growth in women but not men, and there was a significant interaction between treatment and UA levels on infarct growth in women but not in men. Infarct growth decreased in women with higher AL/UA ratio at 6 to 12 hours after UA treatment; this correlation was not significant in men.
Study limitations were the smaller cohort of patients who had multimodal brain imaging, or serum samples collected for evaluation, the authors said.
"This exploratory reanalysis of the URICO-ICTUS trial highlighted the clinical value of the administration of UA in women with acute ischemic stroke who received thrombolysis within 4.5 hours of clinical onset," the authors wrote. "Given the major practical implications that could be derived in the field of acute ischemic stroke, larger confirmatory studies will be urgently required to confirm these encouraging results."