Stroke Risk Factors on the Rise?

So rather than analyzing how to solve all the problems in stroke they took the lazy way out and analyzed risk. We have ZERO leadership in stroke, LEADERS tackle the difficult problems they don't ignore them or run away from them.
https://www.medpagetoday.com/Neurology/Strokes/68482?

Prevalence grew in hospitalized stroke patients each year

• by Kristin Jenkins, Contributing Writer, MedPage Today October 11, 2017

Action Points

• Note that this analysis of the National Inpatient Sample found an increasing prevalence of risk factors for stroke among those who had stroke.
• This is not the same as a finding that risk factors have increased in the overall population, as stroke prevention efforts may successfully concentrate the burden of strokes in higher-risk individuals.

Stroke patients have had a rising prevalence of risk factors -- including hypertension, dyslipidemia, and smoking -- over the last decade, researchers found.
Analysis of the 2004–2014 National Inpatient Sample showed that the proportion of patients with acute ischemic stroke who had at least one risk factor for the disease rose from 88.3% in 2004 to 95% in 2014, according to Fadar Oliver Otite, MD, ScM, from the University of Miami Miller School of Medicine in Florida, and colleagues.
Regression analyses showed that the prevalence of hypertension among these patients rose annually by 1.4%, diabetes by 2%, dyslipidemia by 7%, smoking by 5%, and drug abuse by 7%, they reported online in Neurology. Prevalence of chronic renal failure rose each year by 13%, carotid stenosis by 6%, and coronary artery disease by 1%.
In a statement, Otite said about 80% of all first strokes are caused by preventable risk factors such as hypertension: "Many efforts have been made to prevent, screen for, and treat these risk factors. Yet we saw a widespread increase in the number of stroke patients with one or more risk factors."
"Focusing on risk factor control is critical for stroke prevention," he and colleagues wrote in their paper. "Our alarming findings support the call for further concerted action from all stakeholders to more effectively implement evidence-based interventions to reduce stroke risk."
They looked at data on 922,451 primary acute ischemic stroke admissions from the 2004–2014 National Inpatient Sample. Overall, 92.5% of patients with acute ischemic stroke had at least one risk factor for the disease during that time.
Overall age- and sex-adjusted prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse were 79%, 34%, 47%, 15%, and 2%, respectively. During the same period, the prevalence of carotid stenosis was 13%, chronic renal failure 12%, and coronary artery disease 27%.
Risk factor prevalence varied by age, race, and sex, they noted. While 79.1% of all stroke patients had comorbid hypertension, it was slightly higher in women than in men (80% versus 78.1%, P<0.001), and the prevalence of comorbid diabetes was higher in Hispanic and black patients than in whites (48.7% and 44.4% versus 30.5%). Smoking prevalence increased by 70% between 2004 and 2014, mostly in young and middle-aged patients.
The authors noted that the prevalence of hospital admissions for stroke that had concomitant hypertension, diabetes, and dyslipidemia increased by more than 200%, from 9.4% to 23.7%, during the study period.
In an accompanying editorial, Shyam Prabhakaran, MD, MS, of Northwestern University in Chicago, warned against rushing to judgment about healthcare performance in the U.S. without a more careful inspection of the data.
Factors such as the non-standardized definitions of risk factors within the NIS dataset, and the subsequent lack of data on risk factor management and control "provides little insight" into what's actually happening, he said.
"Thus, instead of a national crisis of increasing risk factors among stroke patients, these same data could imply improved screening and diagnosis of multiple stroke risk factors prior to or at the time of stroke occurrence."
The lack of data on duration of exposure to risk factors and incidence of stroke also makes it impossible to assign causality, Prabhakaran said, noting that since more people with multiple risk factors survive longer, increasing prevalence can also be explained by declines in cardiovascular and stroke mortality.
"For these reasons, prevalence, especially in isolation, may not serve as a good marker of the state of public health in the United States," he wrote. "So, while there should indeed be a call to action to prevent stroke and its negative consequences on society, we should acknowledge important progress that has been made in stroke prevention, even if there is much more work to be done. We should also continue to search for data that measure the health of our society, but remain cautious in interpreting them in a vacuum or without the appropriate context."

This study received no direct funding. The study authors and the editorialist reported no conflicts of interest.

• Reviewed by F. Perry Wilson, MD, MSCE Assistant Professor, Section of Nephrology, Yale School of Medicine and Dorothy Caputo, MA, BSN, RN, Nurse Planner

• Primary Source

  Neurology

  Source Reference: Otite FO, et al "Increasing prevalence of vascular risk factors in patients with stroke: A call to action" Neurol 2017.

• Secondary Source

  Neurology

  Source Reference: Prabhakaran S "Big data trends in stroke epidemiology in the United States: But are they good data?" Neurol 2017.

Risk factors for heart disease and stroke also tied to Alzheimer’s

Ask your doctor how to prevent these problems. S/he should have exact protocols for this.
The readable article here:

Risk factors for heart disease and stroke also tied to Alzheimer’s

The research backing it up here:

Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition

Heart disease, stroke risk factors may increase in severity before menopause

Women be careful out there.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=166592&CultureCode=en
The severity of key risk factors for heart disease, diabetes and stroke appears to increase more rapidly in the years leading up to menopause, rather than after, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.
The study also found that this pattern of rapidly increasing risk factors before menopause appears to be more pronounced among African-American women.
The risk factors, together known as metabolic syndrome, include a large waistline, high triglyceride (a blood fat) levels, low HDL (the “good” cholesterol) levels, high blood pressure and high blood sugar when fasting.
“Previous research showed that after menopause, women were at much greater risk for metabolic syndrome than before menopause began,” said Mark DeBoer, M.D., MSc., M.C.C., study senior author and an association professor of pediatric endocrinology at the University of Virginia in Charlottesville. “This latest study indicates that the increased risk observed earlier may be related more to the changes happening as women go through menopause and less to the changes that take place after menopause.”
Researchers analyzed the records of 1,470 African-American and white women participating in the Atherosclerosis Risk in Communities Study, a national study of the causes and health effects of hardening of the arteries. Participants were selected based on whether they went through menopausal changes over a 10-year period. Each participant was assigned a metabolic syndrome severity score based on a formula the authors developed that has been adopted by other researchers.
After taking into account hormone replacement therapy and other factors that might bias results, the study found:

• Women experienced rapid increases in metabolic syndrome severity during the last years of pre-menopause and the transition years to menopause, known as perimenopause.
• African-American women experienced a much more rapid increase in metabolic syndrome severity before menopause, but a slower rate of increase after menopause, than white women.
• Overall, African-American women had higher rates of metabolic syndrome, particularly high blood pressure and high fasting blood sugar levels, than white women at the beginning of the study.

These findings confirm many previous studies that show African-American women are at greater risk for cardiovascular disease and diabetes than white women.
DeBoer said study results provide physicians and other healthcare providers with an opportunity to motivate women to make lifestyle changes that will decrease their risk of having a heart attack, stroke or developing diabetes.
“Of course, you could argue that all of us should be eating better and making sure we’re getting enough exercise,” he said. “That’s definitely true, but the years transitioning to menopause may represent a ‘teachable moment,’ when patients are especially receptive to learning and putting into practice healthy habits that can make a difference in their cardiovascular disease risk.”
DeBoer noted that their approach to assessing metabolic syndrome severity was originally created to assess risk in children. Adapting the formula to adult patients, he said, advanced the researchers’ hope of one day incorporating risk factor information into an electronic medical record so that metabolic syndrome severity is calculated automatically and available to all patients throughout their lifetime.
Co-authors are Matthew J. Gurka, Ph.D.; Abhishek Vishnu, Ph.D.; and Richard A. Santen, M.D.
Author disclosures are on the manuscript.
The National Institutes of Health supported the study.
http://newsroom.heart.org/news/heart-disease-stroke-risk-factors-may-increase-in-severity-before-menopause?preview=bbe6b80d65da82a56ff05c00af0e6cd4

• Full bibliographic informationProgression of Metabolic Syndrome Severity during the Menopausal Transition
  Co-authors are Matthew J. Gurka, Ph.D.; Abhishek Vishnu, Ph.D.; and Richard A. Santen, M.D.
  Journal of the American Heart Association
  (Manuscript number: JAHA/2016/003609R1)

Nearly All Strokes Globally Have Avoidable Element

Guargantuan Fucking Whoopee.

It means that your stroke doctors , stroke hospitals and stroke associations can continue to do nothing, as they have since forever, to solve all of the problems in stroke. Blame the patient and do conscience laundering. Fucking lazy assholes.

 

Nearly All Strokes Globally Have Avoidable Element

Behaviors, metabolic factors, and air pollution found key contributors

• by Gloria Rothenberg
  MedPage Today Intern

• This article is a collaboration between MedPage Today® and:
  

Action Points

• Globally, stroke is almost entirely caused by modifiable risk factors, with air pollution emerging as a significant contributor.
• Note that almost 30% of the burden of stroke was attributed to air pollution.

Globally, stroke is almost entirely caused by modifiable risk factors, with air pollution emerging as a significant contributor, a systematic analysis showed.
Modifiable risk factors were determined responsible for 90.5% (95% uncertainty interval 88.5-92.2) of the global stroke burden, as measured using disability-adjusted life years, Valery Feigin MD, PhD, of New Zealand's Aukland University of Technology, and colleagues reported online in Lancet Neurology.
Potentially modifiable behaviors -- smoking, poor diet, and physical inactivity -- contributed to 74.2% of strokes (95% UI 70.7-76.7). Metabolic factors -- high systolic blood pressure, high body mass index (BMI), high fasting plasma glucose, high total cholesterol, and low glomerular filtration rate -- were attributable for 72.4% (95% UI 70.2-73.5).
The researchers also called attention to the "unexpectedly high" 29.2% (95% UI 28.2-29.6) of the burden of stroke attributed to air pollution.
This factor had a strong association with stroke burden in Central, Eastern, and Western sub-Saharan Africa, and South Asia, but a lower association with stroke burden in North America, most areas of Europe, Australasia, and Asia Pacific. This exemplified the variations in low- and middle- income countries and high-income countries.
"Air pollution has emerged as a significant contributor to global stroke burden, especially in low-income and middle-income countries, and therefore reducing exposure to air pollution should be one of the main priorities to reduce stroke burden in these countries," they wrote.
In an accompanying editorial, Vladimir Hachinski MD, of the University of Western Ontario in London, and Mahmoud Reza Azarpazhooh, MD, of Iran's Mashhad University of Medical Sciences, agreed, calling the percentage of strokes attributable to air pollution "alarming."
Their Global Burden of Disease Study 2013 included data from 188 countries from 1990 through 2013. Theoretical Minimum Risk Exposure Levels were used to assess levels of relevant exposures to a population for the 17 risk factors identified. Finally, the population-attributable fraction was calculated in order to determine the theoretical effect of mitigating each risk factor.
In addition to individual risk factors, clusters of risk factors were also assessed. These clusters of factors included behavioural, dietary, environmental and occupational, and metabolic categories of risk.
Notably, 71.7% of the disability-adjusted life years that were lost to stroke were in patients under 70 years of age.
The five risk factors associated with the strongest impact on disability-adjusted life years in developed countries were high systolic blood pressure, high BMI, diet low in fruits, diet low in vegetables, and smoking. The five risk factors with the strongest impact on disability-adjusted life years in developing countries were high systolic blood pressure, diet low in fruits, high BMI, diet high in sodium, and smoking.
Whereas most risk factors showed a downward trend in their contribution to stroke in high-income countries, a diet high in sugar-sweetened beverages was the exception. Over the course of the study, there was an almost 84% increase in stroke-related disability-adjusted life years from sugary drinks in high-income countries, compared with a 64% increase in its contribution globally.
Overall, the burden of risk was higher in developing countries than it was in developed countries, and almost all of the risk factors had a stronger effect on disability-adjusted life years in the low- and middle- income countries.
One limitation of the study was that atrial fibrillation, substance abuse, and some other risk factors were not assessed due to lack of data. One perplexing paradox indicated that in developing countries there was a decrease in second-hand smoke, yet an increase in tobacco smoking.
The editorial also noted that the cross-sectional, as opposed to longitudinal, study design likely led to underestimation of the global prevalence of stroke and its associated risk factors. However, it called the "monumental task" of pulling together the attributable risk data a success that "provides a firm basis for policy makers to implement preventative measures."

Will You See Your 80th Birthday?

You Need A Health Turnaround To Make it to Age 80.  
Will You See Your 80th Birthday? 

You may be unlucky - with uncontrollable risk factors that can contribute to an early death - or you may not being taking proper care of your health, but your life expectancy outlook doesn't look good. Even though people who live very unhealthy lifestyles sometimes live past the age of 100, that's not the case for the majority of us. So why not start doing your part to increase the odds of living longer and avoiding the top three causes of premature deaths: heart disease, cancer and stroke? To maximize the chances of living past 80 years old, you should:

• Try to live in an area with healthy air quality to limit your exposure to air pollutants that may cause cancer and accelerate aging. I do.
• Get an education to help increase your socioeconomic status, which increases your chance of receiving things such as quality health care. I do.
• Learn to deal with stress and anger more effectively for health and safety reasons. I do.
• Don't smoke or use other tobacco products, which contribute to 20% of cancer deaths. I do.
• Drink alcohol in moderation. I do.
• Eat a diet high in fruits, vegetables, whole grains, lean protein and low-fat dairy. Avoid processed foods, saturated fats and trans fats. This will also help you maintain a healthy weight. I do.
• Exercise at least three times per week for a minimum of 30 minutes. I do.
• Have regular check-ups with your doctor, especially as you get older, to screen for risk factors associated with cancer, heart disease, diabetes and other diseases. Also let your doctor know what your family's health history looks like. I don't.
• Always wear your seat belt to help prevent accidental deaths. And don't forget to drive safely! I do.

It takes way too long to get thru the quiz to determine why they think I won't make it to 80. I will get there however.