Stroke subtypes: Type 1 and 2 women face greater risk
Filed under: Type 1, Type 2, Research, Complications
Just out in the new issue of Diabetes Care: a report that diabetic women are more at risk for the various stroke subtypes. (Today is just a day for bad health news, I guess. See my previous blog on trauma injuries.) Stroke, as you may already know, is where blood supply to the brain is restricted or cut off. The study's authors tracked the progress of 116,316 women through middle age during the period 1976 to 2002. That's a lotta women... They found the women with diabetes were at a higher risk for stroke, generally: four times higher than that of the general population for women with Type 1 diabetes, and twice as high for women with Type 2 diabetes.
That people with diabetes face a higher risk of stroke is not new. What is new? This study also looked at stroke subtypes and relative risk for women with and without diabetes for each of those subtypes. Some results: ischemic stroke (caused by a blood clot to the brain) risk was 6.3 times higher for T1 diabetics, 2.3 times higher for T2 diabetics. The risk for large-artery infarction and lacunar stroke was similar. The study also concluded that while Type 1 diabetic women face a higher risk of hemorrhagic stroke (where bleeding occurs in the brain or between the brain and the skull), Type 2 women did not.
This study was funded by the National Institutes of Health.
Read more about strokes and learn how to recognize signs of stroke by visiting some of the excellent Web-based resources out there. A good starting point is InteliHealth's section on stroke or visit the National Stroke Association's website. You could save someone's life!
[RESEARCH] Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial
Objective To determine the effect of calcium supplementation on myocardial infarction, stroke, and sudden death in healthy postmenopausal women.
Design Randomised, placebo controlled trial.
Setting Academic medical centre in an urban setting in New Zealand.
Participants 1471 postmenopausal women (mean age 74): 732 were randomised to calcium supplementation and 739 to placebo.
Main outcome measures Adverse cardiovascular events over five years: death, sudden death, myocardial infarction, angina, other chest pain, stroke, transient ischaemic attack, and a composite end point of myocardial infarction, stroke, or sudden death.
Results Myocardial infarction was more commonly reported in the calcium group than in the placebo group (45 events in 31 women v 19 events in 14 women, P=0.01). The composite end point of myocardial infarction, stroke, or sudden death was also more common in the calcium group (101 events in 69 women v 54 events in 42 women, P=0.008). After adjudication myocardial infarction remained more common in the calcium group (24 events in 21 women v 10 events in 10 women, relative risk 2.12, 95% confidence interval 1.01 to 4.47). For the composite end point 61 events were verified in 51 women in the calcium group and 36 events in 35 women in the placebo group (relative risk 1.47, 0.97 to 2.23). When unreported events were added from the national database of hospital admissions in New Zealand the relative risk of myocardial infarction was 1.49 (0.86 to 2.57) and that of the composite end point was 1.21 (0.84 to 1.74). The respective rate ratios were 1.67 (95% confidence intervals 0.98 to 2.87) and 1.43 (1.01 to 2.04); event rates: placebo 16.3/1000 person years, calcium 23.3/1000 person years. For stroke (including unreported events) the relative risk was 1.37 (0.83 to 2.28) and the rate ratio was 1.45 (0.88 to 2.49).
Conclusion Calcium supplementation in healthy postmenopausal women is associated with upward trends in cardiovascular event rates. This potentially detrimental effect should be balanced against the likely benefits of calcium on bone.
Trial registration Australian Clinical Trials Registry ACTRN 012605000242628.
A lost bankcard gets a faster response than stroke symptoms?
Filed under: Daily news
Maybe if we all took our health as seriously as we do our money we'd be better off. The recent results of a study, which can only be described as shameful, show that the majority of people would react faster to a stolen bankcard than they would to the symptoms of a stroke. Like heart attacks, it seems many people don't know what the symptoms of a stroke are and don't really want to believe it's happening to them. Of the people surveyed, those taking the longest to seek medical help were people over 65 -- the very people at the highest risk.Symptoms of a stroke include facial weakness, arm weakness, and speech problems. Strokes can cause immediate and devastating brain damage, with every minute critical to recovery, so if you even suspect a stroke please act immediately.
Living near traffic can cause a stroke
Filed under: Prevention, Research
There's getting to be less and less rural countryside on this planet as our population expands and our cities grow -- and unfortunately it's not doing good things for our health. Studies show that living near high traffic urban areas has a directly negative affect on heart health by increasing a person's risk for developing atherosclerosis and therefore also increasing a person's risk for heart disease and stroke. The biggest risk is for people living within 50 meters (or 160 feet) of major traffic. They suffer a 63% greater risk of heart problems compared to people living 200 meters or farther from traffic.But what do they consider major traffic? New York City I'm sure, but what about living near an interstate in Iowa?
[RESEARCH] Case-control study of self reported genitourinary infections and risk of gastroschisis: findings from the national birth defects prevention study, 1997-2003
Objective To assess the association between genitourinary infections in the month before conception to the end of the first trimesterand gastroschisis.
Design Case-control study with self reported infections from a computer assisted telephone interview.
Setting National birth defects prevention study, a multisite, population based study including 10 surveillance systems for birth defects in the United States.
Participants Mothers of 505 offspring with gastroschisis and 4924 healthy liveborn infants as controls.
Main outcome measure Adjusted odds ratios for gastroschisis with 95% confidence intervals.
Results About 16% (n=81) of case mothers and 9% (n=425) of control mothers reported a genitourinary infection in the relevant time period; 4% (n=21) and 2% (n=98) reported a sexually transmitted infection and 13% (n=67) and 7% (n=338) reported a urinary tract infection, respectively. Case mothers aged <25 years reported higher rates of urinary tract infection alone and in combination with a sexually transmitted infection compared with control mothers. In women who reported both types of infection, there was a greater risk of gastroschisis in offspring (adjusted odds ratio 4.0, 95% confidence interval 1.4 to 11.6).
Conclusion There is a significant association between self reported urinary tract infection plus sexually transmitted infection just before conception and in early pregnancy and gastroschisis.
[RESEARCH] Folic acid supplements and risk of facial clefts: national population based case-control study
Objective To explore the role of folic acid supplements, dietary folates, and multivitamins in the prevention of facial clefts.
Design National population based case-control study.
Setting Infants born 1996-2001 in Norway.
Participants 377 infants with cleft lip with or without cleft palate; 196 infants with cleft palate alone; 763 controls.
Main outcome measures Association of facial clefts with maternal intake of folic acid supplements, multivitamins, and folates in diet.
Results Folic acid supplementation during early pregnancy (≥400 µg/day) was associated with a reduced risk of isolated cleft lip with or without cleft palate after adjustment for multivitamins, smoking, and other potential confounding factors (adjusted odds ratio 0.61, 95% confidence interval 0.39 to 0.96). Independent of supplements, diets rich in fruits, vegetables, and other high folate containing foods reduced the risk somewhat (adjusted odds ratio 0.75, 0.50 to 1.11). The lowest risk of cleft lip was among women with folate rich diets who also took folic acid supplements and multivitamins (0.36, 0.17 to 0.77). Folic acid provided no protection against cleft palate alone (1.07, 0.56 to 2.03).
Conclusions Folic acid supplements during early pregnancy seem to reduce the risk of isolated cleft lip (with or without cleft palate) by about a third. Other vitamins and dietary factors may provide additional benefit.
No Benefit Found for Post-Stroke Tight Glucose Control
Filed under: Type 1, Type 2, Childhood, Adult Onset, Research
British researchers have found that tight glucose control during hospitalization for a stroke may not improve survivalThe study involved 933 patients enrolled within 24 hours of a stroke who had glucose in the range of 6.0 to 17 mmol/l. Participants received saline solution or continuous glucose, potassium, insulin infusions to reduce their blood glucose. Patients were monitored every two hours with glucose adjusted if needed every eight hours. The researchers found that both treatment and placebo groups had improvement in glucose levels. The treatment group had an overall mean 0.57 mmol/l reduction in glucose over 24 hours while glucose levels also fell spontaneously with simple saline hydration. There was also no difference in the secondary outcome of disability. There was a significant reduction in systolic blood pressure in the treatment group. A researcher noted, "In the majority of patients, treatment with a simple saline infusion will correct mild to moderate hyperglycemia."
The saline and glucose relationship is similar to the way the noninvasive glucose monitors measure blood sugar (aka Glucowatch)., This relationship between sodium and glucose in the blood moves inverse. When your sugar levels are elevated, your sodium is down. When you force sodium into your blood, your sugar is suppressed. Doctors must proceed with caution in light of this study. When it comes to aggressively lowering glucose, especially after a trauma, it could be more harmful than helpful.
What's the deal with aspirin and strokes?
Filed under: Drugs, Daily news, Women Heart Health, Men Heart Health, Aging Heart Health
It's a pretty well-known belief that taking an aspirin a day will reduce your risk of stroke. Actually, it's pretty much regarded as a proven fact, although this thinking might have to be changed as it's also being said that Aspirin may in fact increase your chance of a stroke. According to experts, the risks associated with Aspirin outweigh the benefits, though the risks of taking Aspirin are not specified. Nonetheless, I think it's bad practice to take any sort of drug every day unless ordered by your doctor.This just goes to show that you can't believe everything you read or hear, even if it is regarded as fact.
[RESEARCH] Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2
Objective To develop and validate version two of the QRISK cardiovascular disease risk algorithm (QRISK2) to provide accurate estimates of cardiovascular risk in patients from different ethnic groups in England and Wales and to compare its performance with the modified version of Framingham score recommended by the National Institute for Health and Clinical Excellence (NICE).
Design Prospective open cohort study with routinely collected data from general practice, 1 January 1993 to 31 March 2008.
Setting 531 practices in England and Wales contributing to the national QRESEARCH database.
Participants 2.3 million patients aged 35-74 (over 16 million person years) with 140 000 cardiovascular events. Overall population (derivation and validation cohorts) comprised 2.22 million people who were white or whose ethnic group was not recorded, 22 013 south Asian, 11 595 black African, 10 402 black Caribbean, and 19 792 from Chinese or other Asian or other ethnic groups.
Main outcome measures First (incident) diagnosis of cardiovascular disease (coronary heart disease, stroke, and transient ischaemic attack) recorded in general practice records or linked Office for National Statistics death certificates. Risk factors included self assigned ethnicity, age, sex, smoking status, systolic blood pressure, ratio of total serum cholesterol:high density lipoprotein cholesterol, body mass index, family history of coronary heart disease in first degree relative under 60 years, Townsend deprivation score, treated hypertension, type 2 diabetes, renal disease, atrial fibrillation, and rheumatoid arthritis.
Results The validation statistics indicated that QRISK2 had improved discrimination and calibration compared with the modified Framingham score. The QRISK2 algorithm explained 43% of the variation in women and 38% in men compared with 39% and 35%, respectively, by the modified Framingham score. Of the 112 156 patients classified as high risk (that is, ≥20% risk over 10 years) by the modified Framingham score, 46 094 (41.1%) would be reclassified at low risk with QRISK2. The 10 year observed risk among these reclassified patients was 16.6% (95% confidence interval 16.1% to 17.0%)—that is, below the 20% treatment threshold. Of the 78 024 patients classified at high risk on QRISK2, 11 962 (15.3%) would be reclassified at low risk by the modified Framingham score. The 10 year observed risk among these patients was 23.3% (22.2% to 24.4%)—that is, above the 20% threshold. In the validation cohort, the annual incidence rate of cardiovascular events among those with a QRISK2 score of ≥20% was 30.6 per 1000 person years (29.8 to 31.5) for women and 32.5 per 1000 person years (31.9 to 33.1) for men. The corresponding figures for the modified Framingham equation were 25.7 per 1000 person years (25.0 to 26.3) for women and 26.4 (26.0 to 26.8) for men). At the 20% threshold, the population identified by QRISK2 was at higher risk of a CV event than the population identified by the Framingham score.
Conclusions Incorporating ethnicity, deprivation, and other clinical conditions into the QRISK2 algorithm for risk of cardiovascular disease improves the accuracy of identification of those at high risk in a nationally representative population. At the 20% threshold, QRISK2 is likely to be a more efficient and equitable tool for treatment decisions for the primary prevention of cardiovascular disease. As the validation was performed in a similar population to the population from which the algorithm was derived, it potentially has a "home advantage." Further validation in other populations is therefore advised.
Super Bowl Diabetes Sighting
Filed under: Type 1, Type 2, Adult Onset, Lifestyle, Events, Products, Support
Yes sports fans -- diabetes did make a cameo at the Super Bowl. Did you see her?
The notorious commercials-- costing several million a pop- livened up the intensity of the game. The K-fed commercial had a reputation a long time ago - and passed it, with flying colors! The commercial of diabetic interest was paid for by King Pharmaceuticals. It featured a man dressed as a heart, being chased by different factors that can wear and tear on your little pumper. Of course, the role of "diabetes" was portrayed wonderfully by a woman. Hell hath no fury, people. And the message?
The ad is promoting an educational site that King Pharmaceuticals has partnered with the American Heart Association to launch. The site is named beatyourrisk.com. The chief commercial officer for King Pharmaceuticals said, "The purpose of the ad is to raise awareness for the Web site to any extent possible and educate people that they are at serious risk. This is not toenail fungus. People can die." So true! And after you finish cleaning up the remains of the potato chips, wings, and beer - check out the site and rejoice in preventative education!