Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 34,264 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective 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.
Showing posts with label stroke risk factor. Show all posts
Showing posts with label stroke risk factor. Show all posts
Background and purpose:
Considering the reliance of serum uric acid (SUA) levels on renal
clearance function, its role in stroke outcomes remains controversial.
This study investigated the association of renal function-normalized SUA
(SUA to serum creatinine ratio, SUA/SCr), a novel renal function index,
with the 1-year outcomes in patients with acute ischemic stroke (AIS).
Methods:
This is a prospective, multicenter observational study. Renal
function-normalized SUA levels were determined by calculating the ratio
of SUA to SCr. One-year outcomes included stroke recurrence, all-cause
mortality, and poor prognosis. Multivariable Cox regression analyses and
restriction cubic splines for curve fitting were used to evaluate
SUA/SCr's association with 1-year stroke outcomes.
Results:
Among 2294 enrolled patients, after adjustment for potential
confounders, multivariable Cox regression analyses showed that each
one-unit increase in SUA/SCr corresponded to a 19% decrease in 1-year
stroke recurrence in patients with AIS. SUA/SCr was analyzed as a
continuous variable and categorized into quartiles (Q1-Q4). Compared
with the Q1 reference group, Q2, Q3, and Q4 showed significantly lower
1-year stroke recurrence risks. The trend test indicated significant
differences in the 1-year stroke recurrence trend from Q1 to Q4. In
these patients, SUA/SCr did not show a significant association with poor
prognosis or all-cause mortality. Curve fitting revealed SUA/SCr had a
negative but nonlinear association with 1-year stroke recurrence.
Conclusions:
In patients with AIS, low SUA/SCr may be an independent risk
factor for 1-year stroke recurrence. Changes in SUA/SCr had no
significant impact on 1-year poor prognosis and all-cause mortality.
This is pure laziness, telling us that 90% of strokes could be prevented, rather than doing the hard job of solving stroke to 100% recovery! IS THAT TOO FUCKING HARD? Try recovering from a stroke with shitworthy guidelines instead of EXACT PROTOCOLS! They will want 100% recovery after they become the 1 in 4 per WHO that has a stroke : and by then it will be too late.
Diabetes, diet quality and lack of physical activity were linked to increased odds of stroke.
Those with non-severe stroke were younger than those with severe stroke by country income level.
Hypertension, atrial fibrillation and smoking were most strongly
associated with an increased risk for severe compared with non-severe
stroke, according to analysis from the INTERSTROKE study.
“Public health interventions to reduce the burden of stroke may reasonably prioritize the prevention of disabling stroke,” Catriona Reddin, MB, BCh, BAO, MSc, of the School of Medicine at the University of Galway in Ireland, and colleagues wrote in Neurology.
“Accordingly, a detailed knowledge of whether the magnitude of
association of traditional vascular risk factors with acute stroke
differs by stroke severity may refine global stroke prevention
strategies.”
The latest study analysis from Ireland found a host of
cardiovascular factors, hypertension chief among them, are most strongly
associated with risk for severe stroke in a cohort of those diagnosed
with acute stroke.Image: Adobe Stock
Reddin and colleagues sought to determine whether individual risk factors for acute stroke
differed by stroke severity. They analyzed the results of INTERSTROKE,
an international case-control study, which showed that 10 potential
modifiable risk factors were associated with 90% of the study
population’s attributable risk for stroke when controlling for both age
and sex.
INTERSTROKE recruited more than 13,000 individuals with stroke and
more than 13,000 matched controls from 32 countries between 2007 and
2015, for which stroke severity was measured by modified Rankin Scale
(mRS) score (with severe stroke defined as scores 4 to 6 and non-severe 0
to 3) within 72 hours of hospital admission. (My mRS score was 3)
Risk factors associated with stroke were measured via self-reported
standardized questionnaires that collected baseline demographics and a
range of lifestyle-related stroke risk factors, including blood
pressure, diabetes risk, smoking, cardiovascular health, stress,
depression, exercise and diet quality.(I was great at all of these, the problem was hereditary, my Dad had carotid blockage which his doctor never told him to have his children checked for plaque blockage. So my stroke was completely preventable, yet nothing here addresses that.)
The researchers conducted a matched case-case analysis based on age,
sex, country and primary stroke subtype to determine if a significant
difference existed in prevalence of risk factors among study individuals
with severe and non-severe stroke.
From 13,460 enrollees with stroke, 64% (n = 8,612) reported mRS scores of 0 to 3 and 36% (n = 4,848) reported scores of 4 to 6.
According to the results, hypertension (OR = 3.21; 95% CI, 2.97–3.47
for severe stroke; OR = 2.87; 95% CI, 2.69–3.05 for non-severe stroke),
atrial fibrillation (OR = 4.7; 95% CI, 4.05–5.45 for severe stroke; OR =
3.61; 95% CI, 3.16–4.13 for non-severe stroke) and smoking (OR = 1.87;
95% CI, 1.72–2.03 for severe stroke; OR = 1.65; 95% CI, 1.54–1.77 for
non-severe stroke) had a stronger association with severe stroke
compared with non-severe stroke.
Reddin and colleagues also found that diabetes, lower diet quality and lack of physical activity were associated with increased odds of both severe and non-severe stroke,
with no significant difference in odds among both groups; alcohol use
was associated with increased odds of non-severe but not severe stroke.
Data additionally showed that individuals with non-severe stroke were
younger than those with severe stroke when analyzed by country income
level.
“All risk factors were significantly associated with both severe and
non-severe stroke symptoms but to varying magnitudes,” Reddin and
colleagues wrote. “Our findings emphasize the importance of hypertension
control in stroke prevention.”
Researchers have developed a laser-based device that can be placed on
the head to non-invasively monitor changes in brain blood flow and
volume. The new device could one day help save lives by offering a
direct and simple way to assess stroke risk based on physiological
markers rather than indirect markers like lifestyle factors.
Strokes occur when blood flow to the brain is blocked or reduced,
causing debilitating brain cell damage. With about 15 million people
worldwide affected by strokes each year, it is the second leading cause
of death and a leading cause of long-term disability.
"The lack of a cost-effective and scalable stroke risk assessment
system complicates long-term stroke prevention because a physician can't
tell whether a patient's risk is stable or worsening," said research
team member Simon Mahler, a postdoctoral scholar in Changhuei Yang's
laboratory at the California Institute of Technology. "This new method
could help catch early signs of increased stroke risk, which is key to
lowering the chances of having a stroke and reducing stroke severity."
In the Optica Publishing Group journal Biomedical Optics Express,
the researchers describe their approach, which uses speckle contrast
optical spectroscopy (SCOS) to track changes in blood flow and volume
during a breath-holding exercise. They report that the portable system
was able to differentiate between low and high stroke risk in a group of
50 volunteers. The work is part of a larger collaboration led by Yang
and Charles Liu from the University of Southern California.
This approach could one day be incorporated into the regular testing
performed during annual physical examinations, providing physicians with
crucial information about the patient's health. It could be
particularly beneficial for communities with limited access to advanced
medical facilities and has the potential to lead to personalized
strategies for reducing stroke risk."
Charles Liu, University of Southern California
Spectroscopy on the go
For the past 40 years, researchers have been experimenting with
various methods to measure blood flow in the brain and changes
associated with stroke risk. Measuring blood flow when the brain is
stressed, such as during breath holding, can be used to assess the risk
of stroke.
Although imaging techniques like PET, SPECT and CT can reveal changes
in blood flow, they are expensive and aren't easy to use in clinics or
for widespread community screening. To solve this
challenge, the researchers turned to SCOS as a more practical way to
access changes in blood flow and volume in the brain. They built a
simple, portable spectroscopy system that consists of a laser diode and a
CMOS-based camera that can be placed on the head with no external
optical elements.
SCOS
works by shining an infrared laser or light onto the brain and
analyzing the patterns of scattered light. The infrared light can
penetrate the skull and brain, producing a back-scattered speckle
pattern that varies with changes in blood flow and tissue oxygenation.
Using a coherent laser makes it possible to determine brain blood flow
rate by calculating how fast the captured laser speckle field
fluctuates, which speeds up with faster blood flow.
Simplified blood flow assessment
"As people age their blood vessels get stiffer, making them more
prone to stroke," said Yang. "By asking a person to hold their breath,
we can use SCOS to measure how much the blood vessels expand and how
much faster blood is flowing within the vessels in response. These
reactive measurements are indicative of vessel stiffness, and such
measurement capabilities are unique to transcranial optical methods."
The researchers tested the SCOS method with 50 people who were
divided into low- and high-risk stroke groups based on a stroke risk
assessment performed with the Cleveland Stroke Risk Calculator. The
researchers found that blood flow and blood volume changes were
significantly different between the two groups and, therefore, have the
potential to serve as physiological markers for stroke risk.
"While the current study is very promising, we are planning
additional studies to further understand the clinical implications of
the laser SCOS recordings in larger patient groups over longer time
periods," said Liu. They are also working to incorporate machine
learning to improve data analysis and further validate the method's
effectiveness.
Fewer strokes with good exercise and diet habits, despite high genetic risk
by Kate Kneisel, Contributing Writer, MedPage Today
Action Points
Genetic and lifestyle factors were independently associated with risk of incident stroke.
Note that the study suggests that adhering to a healthy lifestyle could attenuate the effect of genetics on stroke risk.
Individuals
following a healthy lifestyle had lower stroke risk regardless of
genetic risk factors compared to those with unhealthier habits such as
smoking and poor diet, according to results of a prospective study of
men and women in the UK Biobank database in Great Britain.
The population-based assessment of the independent effects of genetic
and lifestyle factors found that the risk of stroke was 35% higher
among those at high genetic risk compared with those at low genetic risk
(hazard ratio 1.35, 95% CI1.21-1.50), according to Loes C.A.
Rutten-Jacobs, German Center for Neurodegenerative diseases, Bonn,
Germany, and colleagues.
Importantly,
regardless of a person's level of genetic risk, having an unfavorable
lifestyle that included 0 or 1 of 4 healthy lifestyle factors based on
American Heart Association guidelines -- no current smoking, healthy
diet, body mass index <30, and moderate physical activity two or more
times weekly -- was associated with a 66% increased risk of stroke
compared with having a favorable lifestyle that includes three or four
healthy lifestyle factors (HR 1.66, CI 1.45-1.89), the group reported
online in The BMJ.
Rutten-Jacobs and colleagues emphasized that while no firm
conclusions can be drawn about cause and effect from an observational
study, "it might be hypothesized that adhering to a healthy lifestyle
could attenuate the effect of genetics on stroke risk. A previous study in
coronary artery disease (CAD)... found a statistically significant
interplay between genetic and lifestyle risk factors in CAD risk."
A high genetic risk combined with an unfavorable lifestyle profile
was associated with a more than twofold increase in risk of stroke
compared with a low genetic risk and a favorable lifestyle. Of lifestyle
factors, the effect of smoking was strongest -- about twice as strong
as effects of the other individual lifestyle scores.
Asked for his perspective, Gregg C. Fonarow, MD, of the David Geffen
School of Medicine at UCLA in Los Angeles, said the findings reflect a
significant body of research, which has linked both genetic and
lifestyle factors with the risk of stroke.
"Importantly, irrespective of the level of underlying genetic risk, a
healthy lifestyle was associated with lower stroke risk," Fonarow, who
was not involved in the study, told MedPage Today via email.
"Both men and women have higher risk of stroke with unhealthy lifestyles
in this study; however the relative and absolute risks were higher in
men compared to women."
Indeed,
men with an unfavorable lifestyle had a higher relative risk of stroke
than did women with an unfavorable lifestyle (82% versus 36% increased
risk, respectively).
"These same lifestyle interventions [i.e. not smoking, regular
physical activity, healthy diet, and avoiding diabetes] have been shown
to be associated with lower risk of heart disease, thus supporting
benefits in terms of both long-term heart and brain health," Fonarow
added. "Additional studies in more diverse individuals in terms of
race/ethnicity and region of the world may provide additional insights."
The group developed a weighted genetic risk score based on 90
stroke-related gene variants in 306,473 white men and women in the UK
Biobank database and tested its association with incident stroke, and
whether adherence to a healthy lifestyle influenced this association.
Participants were 40 to 73 years old and had no history of stroke or
heart attack.
Genetic risk was divided into thirds, and lifestyle was recorded as
"favorable" (three or four healthy lifestyle factors), "intermediate"
(two healthy lifestyle factors), or "unfavorable" (no or one healthy
lifestyle factor).
During a median follow-up of 7.1 years, 2,077 incident strokes were
noted, the group reported. "The association between genetic risk and
incident stroke was unchanged after adjustment for lifestyle, and the
association of lifestyle with incident stroke was essentially unchanged
after adjustment for the genetic risk score."
Rutten-Jacobs
and colleagues calculated hazard ratios for stroke in participants
classified as having low or high genetic risk, associated with the
following risk factors:
Current smoking: 2.35 (95% CI 1.84-3.01) low risk; 1.87 (95% CI 1.48-2.37) high risk
BMI ≥30: 1.43 (95% CI 1.20-1.71) low risk; 1.19 (95% CI 1.02-1.40) high risk
Lack of regular moderate physical activity: 1.09 (95% CI 0.92-1.28) low risk; 1.09 (95% CI 0.94-1.26) high risk
Unhealthy diet: 1.10 (95% CI 0.93-1.30) low risk; 1.21 (95% CI 1.05-1.40) high risk
These findings "highlight the potential of lifestyle measures to
reduce risk of stroke across entire populations, even in those at high
genetic risk of stroke," noted Rutten-Jacobs and co-authors.
The group acknowledged several limitations, such as the narrow range
of lifestyle factors, and that the study population included only people
of European descent, which limits the findings' generalizability.
This work was
in part supported by the British Heart Foundation. HSM has been paid for
delivering educational presentations for AstraZeneca.
LCAR-J was
supported by a British Heart Foundation; CLS receives salary from UK
Biobank and the Scottish funding Council; MD received funding from the
European Union's Horizon 2020 research and innovation programme; HSM is
supported by a National Institute for Health Research (NIHR) senior
investigator award, and the Cambridge Universities NIHR Comprehensive
Biomedical Research Centre.
Reviewed by Robert Jasmer, MD
Associate Clinical Professor of Medicine, University of California,
San Francisco and Dorothy Caputo,
MA, BSN, RN, Nurse Planner
So rather than solve ANY of the problems in stroke, lets be lazy and just identify more risk factors. God, do we need some stroke leadership that puts a strategy out there for 100% recovery and follows through. Only 425 scientists than need reaming out by the president of that great stroke association to actually solve the correct problems in stroke.
Stroke has multiple etiologies, but the underlying genes and pathways are largely unknown. We conducted a multiancestry genome-wide-association meta-analysis in 521,612 individuals (67,162 cases and 454,450 controls) and discovered 22 new stroke risk loci, bringing the total to 32. We further found shared genetic variation with related vascular traits, including blood pressure, cardiac traits, and venous thromboembolism, at individual loci (n = 18), and using genetic risk scores and linkage-disequilibrium-score regression. Several loci exhibited distinct association and pleiotropy patterns for etiological stroke subtypes. Eleven new susceptibility loci indicate mechanisms not previously implicated in stroke pathophysiology, with prioritization of risk variants and genes accomplished through bioinformatics analyses using extensive functional datasets. Stroke risk loci were significantly enriched in drug targets for antithrombotic therapy.
