Figures published to coincide with World Stroke Day, which falls on Saturday, show that the brain attacks, caused by clots blocking the blood supply, kill someone worldwide every six seconds.

But scientists say that 85 per cent of the victims have risk factors that could have saved them if they led healthier lifestyles.

Research suggests that the easiest ways to cut stroke risk are to take part in physical exercise, eat fresh food, limit alcohol consumption and avoid smoking. Awareness of other medical conditions such as high blood pressure and cholesterol is also important.

Professor Freek Verheugt, speaking on behalf of the European Society of Cardiology, said: “Stroke is not an inevitable consequence of ageing, so by identifying and modifying risk factors there are opportunities to reduce the incidence and mortality rate of this devastating condition.”

An irregular heartbeat can also lead to the blocking of blood vessels that take oxygen to the brain, causing a stroke.

Professor Verheugt said: “All individuals with irregular heart beat should see a doctor, who can diagnose whether this heart rhythm disorder is likely to lead to stroke. If so, blood-thinning medication can reduce the risk of stroke by up to 70 per cent.”

As well as the risk factors, experts say it is also vital that people know the warning signs of a stroke.

These include sudden numbness, trouble speaking, loss of balance and a sudden severe headache with no apparent cause.

The quicker a stroke victim is taken to a dedicated hospital unit the better, as delays can lead to more brain function being lost.

Source: The Telegraph

Phan is co-author of an MRI study of patients who had recently begun taking cholesterol medications. The study found that intensive treatment with cholesterol drugs significantly reduced the amount of cholesterol in artery-clogging plaque. The study is published in the Journal of the American College of Cardiology: Cardiovascular Imaging.

Cholesterol is the raw material in the buildup of plaque, which leads to atherosclerosis (hardening of the arteries). The process can cause blocked arteries that can trigger heart attacks, strokes and other cardiovascular problems.

Imaging technologies traditionally used to monitor cardiovascular disease, such as angiograms and ultrasounds, show the overall size of the plaque buildup. In the new study, MRI scans were more precise, showing the amount of cholesterol within the plaque.

The study was conducted at the University of Washington, where Phan completed a cardiovascular clinical and research fellowship. The study included 120 patients who were randomly assigned to receive one of three cholesterol treatments: Lipitor®; Lipitor plus Niaspan® (extended-release niacin); or Lipitor® plus Niaspan and colesevelam.

After three years, the 33 patients with identified carotid plaques had a significant reduction in the cholesterol within the plaque. The volume of cholesterol dropped from 60.4 cubic millimeters to 37.4 cubic millimeters, and the percentage of plaque volume consisting of cholesterol dropped from 14.2 percent to 7.4 percent.

(The scans were done on patients’ carotid arteries in the neck, rather than on their coronary arteries. Carotid arteries are easier to capture images of because they are closer to the surface of the body and do not move as much as coronary arteries of a beating heart. Since atherosclerosis occurs in blood vessels throughout the body, plaque buildup in carotid arteries is a good representation of what is occurring in coronary arteries.)

The findings confirmed the researchers’ hypothesis that the reason why cholesterol medications shrink the overall size of the plaque is because cholesterol is being removed from within the plaque. Thus, using MRI scans to monitor the amount of cholesterol in plaque may help doctors to better determine how well cholesterol medications are working. If an MRI showed cholesterol was not being reduced, more aggressive therapy might be needed, Phan said.

“In the future, MRI scans may become important and powerful tools to see how medication therapy is working inside arteries,” Phan said. “However, our study is just the first step. Additional studies will be needed.”

Phan’s special interests include cholesterol therapy and preventive cardiology. He is an assistant professor in the Department of Medicine, division of Cardiology, of Loyola University Chicago Stritch School of Medicine.

Other authors of the study are Xue-Qiao Zhao, MD (first author); Li Dong, MD; Tom Hatsukami, MD; Baocheng Chu, MD, PhD; Andrew Moore; Trevor Lane; Moni Neradilek; Nayak Polissar, PhD; Duane Monick, MD; Colin Lee, MD; Hunter Underhill, MD; and Chun Yuan, PhD.

Source: Jim Ritter, Loyola University Health System, via EurekAlert

Increasing levels of high-density lipoproteins, better known as HDL or “good” cholesterol, reduced the risk for heart attack and stroke among patients with diabetes. That’s according to a new study appearing online today in The American Journal of Cardiology.

The observational study, one of the largest of its kind, examined the medical records of more than 30,000 patients with diabetes and also found that patients whose HDL levels decreased had more heart attacks and strokes.

Researchers studied patients with diabetes because they are more prone to heart disease with a lifetime risk as high as 87 percent, according to a paper from the landmark Framingham heart study published 2008. While there is considerable evidence that reducing the amount of low-density lipoprotein, also known as LDL or “bad” cholesterol, can reduce the risk of heart disease, the relationship between HDL cholesterol and heart disease is less clear.

“Our study adds to the growing body of evidence that raising HDL levels may be an important strategy for reducing heart attack risk,” said study lead author Gregory Nichols, PhD, senior investigator with the Kaiser Permanente Center for Health Research in Portland, Ore.

“This is promising news for patients with diabetes, who already have an increased risk for heart problems. Raising their good cholesterol may be one more way for these patients to reduce their risk,” said Suma Vupputuri, PhD, co-author and investigator with the Kaiser Permanente Center for Health Research in Atlanta.

The study included 30,067 patients who entered Kaiser Permanente diabetes registries in Oregon, Washington and Georgia between 2001 and 2006. These patients had at least two HDL cholesterol measurements between 6 and 24 months apart. Most patients (61 percent) had no significant change in HDL levels; in 22 percent of patients, HDL levels increased by at least 6.5 mg/dl (milligrams per deciliter of blood); in 17 percent of patients, HDL levels decreased by at least that same amount. After obtaining the cholesterol measurement, researchers followed the patients for up to 8 years to see if they were hospitalized for a heart attack or stroke. Patients whose HDL levels increased had 8 percent fewer heart attacks and strokes than patients whose HDL levels remained the same, while patients whose HDL levels decreased had 11 percent more heart attacks and strokes. This study was observational so there was no intervention to change HDL levels, and although many patients were on statins to reduce their “bad” cholesterol, very few were on medications to improve HDL.

Past studies on this topic have reached contradictory conclusions. A study published in 2009 in the Archives of Internal Medicine found that for every 5 mg/dl improvement in HDL cholesterol level patients saw a 21 percent decrease in heart attack risk. But a systematic review of more than 100 clinical trials published in the British Medical Journal in 2009 found that increasing HDL cholesterol did not reduce the risk of heart disease or death.

Earlier this year the National Institutes of Health stopped a clinical trial using large doses of the B Vitamin niacin to boost HDL levels because the patients, who were already taking statins to reduce their “bad” cholesterol, saw no added reduction in heart attacks when they added niacin. Niacin is one of very few medications to increase HDL, but it can also have side effects such as flushing, vomiting, dizziness and itching.

People can raise their HDL levels without medication by keeping their weight down, changing their diet, avoiding tobacco smoke, and increasing exercise. Medical experts believe that HDL or “good” cholesterol carries the “bad” cholesterol away from the arteries and back to the liver where it is processed and passed from the body. According to the American Diabetes Association, a good target for women should be at least 50 mg/dl of HDL and for men at least 40 mg/dl. Levels of 60 mg/dl or higher are thought to protect against heart disease.

Source: Emily Schwartz, Kaiser Permanente, via EurekAlert

Patients who use diclofenac, a non-steroidal anti-inflammatory drug (NSAID), had a 40 percent higher risk of heart attack or stroke than those who were not using the drug, according to scientists from the Hull York Medical School, northern England, working with researchers from the Canadian Institute of Clinical Evaluative Sciences in Toronto.

The research, published in the Public Library of Science (PLoS) journal, was based on analysis of 51 international studies involving more than 2.7 million patients.

Lead researcher Patricia McGettigan, from the Hull York Medical School, said, “NSAIDs provide pain relief for millions of patients with chronic inflammatory disorders. The cardiovascular risk is well described but often overlooked.”

She added. “In choosing which one of the many available NSAIDs to use, patients and doctors would benefit from knowledge of the balance between benefit and harm for individual NSAIDs.

For example, diclofenac, the NSAID most commonly prescribed in England in 2010, was associated with an increase in cardiovascular risk of 40 percent, compared with non-use.”

Researchers advised doctors to consider prescribing alternatives to diclofenac such as naproxen and low dose ibuprofen, which were found to be least likely to increase cardiovascular risk.

Source: Fox News

The findings, which will be presented today (26 September 2011) at the European Respiratory Society’s Annual Congress in Amsterdam, suggest that people with COPD and reduced lung function should be routinely screened for cardiovascular disease, as they appear to be at a considerably greater risk of it.

The issue of co-morbidities, when an individual is affected by more than one condition at the same time, is a growing problem for medical professionals. As people are living longer, the presence of co-morbid conditions will increase. Patients are often treated by a specialist for one particular symptom but as the prevalence of co-morbidities increases it will become important for all clinicians to recognise other symptoms.

It is common for patients to have both heart disease and COPD but it is largely unrecognised by doctors because of overlapping clinical manifestations. COPD diagnosis can remain unsuspected in people with heart disease, but having both conditions can lead to a much worse outlook for the individual.

Previously there was very little epidemiological evidence linking the two conditions, but this study is the first to identify that nasal symptoms and cardiovascular disease are common in people with COPD and could link the two conditions.

The researchers collected data on nasal symptoms and cardiovascular disease from 993 patients with COPD and 993 without COPD. In the latter group, the patients were divided into two categories; those with normal lung function and those with restricted lung function. 50.1% of people with COPD had cardiovascular conditions such as heart disease, stroke and hypertension, compared to people with normal lung function (41%).

The results showed that nasal symptoms were common in people who had both COPD and heart disease compared to people with normal lung function: 53% of people with COPD and heart disease had nasal symptoms compared to 35.8% in people with normal lung function and heart disease.

In addition, 62.2% of people with both restricted lung function and heart disease had nasal symptoms, demonstrating that the symptoms could be used as a marker for identifying increased risk of heart disease and COPD in people yet to be diagnosed with either condition.

Dr Anne Lindberg, from the Sunderby Hospital in Sweden, said: “Our findings are the first to shed light on the links between both nasal symptoms and cardiovascular condition, in relation to people with COPD and restrictive lung function. This has important implications for clinicians who need to understand the potential overlaps of these conditions when they are treating people with COPD. In addition to raising awareness of these co-morbidities, it will also be important to investigate these links further and look at the effect that co-morbid conditions have on exacerbations and disease progression. ”

Professor Marc Decramer, President of the European Respiratory Society, said: “Clinicians often forget that people with one chronic condition usually have another illness at the same time. Many of the illnesses that are common alongside COPD, such as cardiovascular disease, may also share similar traits and it is vital that we build on research such as this study to identify new therapeutic targets in the future.

“The European Respiratory Roadmap, which was launched last month, outlines the need for great coordination between medical specialists. As the population is aging, the presence of co-morbidities will increase. The roadmap suggests that clinicians need to improve their recognition of other conditions to improve patient care and look at how to manage COPD in conjunction with other health conditions.”

Source: Lauren Anderson, European Lung Foundation, vua EurekALert