Magnesium may benefit blood pressure
DIETARY sources of magnesium include nuts, seeds, green vegetables and unrefined grains; it plays an important role in the prevention of osteoporosis, cardiovascular disease and diabetes.1
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stroke
The following articles have the tag stroke
Stroke risk double in depressed
DEPRESSED middle-aged women in Australia have almost double the risk of stroke, a study suggests.
Cognitive decline as CVD risks rise
COGNITIVE function may decline in adults from as young as 35 years as heart disease risk factors increase, a study suggests.
Caution with switching warfarin to dabigatran
DOCTORS should exercise caution when changing patients to dabigatran (Pradaxa, Boehringer Ingelheim), an expert has warned, after research found the risks of thrombosis and bleeding were increased in previous warfarin users.
RU-486 subsidy won’t increase abortions: govt
FEDERAL Health Minister Tanya Plibersek says if the government subsidised medical abortion on the PBS, it would not lead to more terminations.
Slow tamoxifen uptake for prevention
INCREASING the uptake of selective oestrogen receptor modulators (SERMs) to prevent breast cancer in higher-risk women requires a cultural shift by doctors and patients, a cancer expert believes.
Australia really is the lucky country
AUSTRALIANS live longer, healthier lives than people in almost every other country, according to a major international study.
Mediterranean diet preserves cognitive function
A MEDITERRANEAN-style diet packed with fish, chicken and olive oil and low on fatty dairy products and meat may lower the risk of cognitive impairment later in life, a large US study says.
Early adulthood obesity predicts disease or death by middle-age
MEN who are obese in their early 20s are three times more likely to develop serious ill health by middle age, research suggests.
Fine particulate pollution linked to atherosclerosis
HIGHER concentrations of fine particulate air pollution have been linked to escalation of atherosclerosis, in a study of more than 5500 US city dwellers without cardiovascular disease at baseline.
Beta-blockers after surgery reduce death risk: study
PERIOPERATIVE beta-blockade is associated with significantly lower rates of mortality in high-risk patients undergoing major non-cardiac, non-vascular surgery, retrospective research shows.
Aspirin warning in diabetes
ASPIRIN offers no benefit for primary prevention of cardiovascular disease in type 2 diabetes patients and may even increase the risk of coronary heart disease, a study shows.
Inquest begins into surgery death in 'beach chair' position
WHEN a former New Zealand rugby union player went into hospital for a routine shoulder operation, no one expected that he would have a massive stroke on the operating table and never wake up again.
MI decline lag could be due to vigilance
AUSTRALIA lags behind other parts of the world in declining trends of myocardial infarction incidence, research suggests.
‘Healthy’ but obese is a transient state
A THIRD of young people who are obese but ‘metabolically healthy’ will transition to a metabolically unhealthy state over time, Australian data shows.
Cannabis a stroke risk in young adults?
AS THE push to legalise cannabis for medical use continues, New Zealand research suggests smoking the substance may double the risk of stroke in young adults.
New guide clarifies role of ablation in AF
THE increasing prevalence of atrial fibrillation (AF), together with some confusion about the optimal use of catheter ablation, has prompted the development of Australia’s first consensus statement to guide treatment of AF.
New guide clarifies catheter ablation
CONFUSION about the optimal use of catheter ablation and the increasing prevalence of atrial fibrillation (AF) has prompted the development of Australia’s first consensus statement to guide treatment.
Stroke patients missing out on lifesaving drug
MANY stroke patients are missing out on a lifesaving declotting drug and four in 10 are treated in general wards rather than specialist stroke units, an advocacy group says.
Trial results reinforce dabigatran safety in AF
AN FDA safety advisory and new clinical trial results are reassuring and add further weight to calls for Pradaxa (dabigatran) to be PBS listed for atrial fibrillation, experts say.
Cardiovascular risk doubles with earlier menopause
WOMEN who experience early menopause – either surgically induced or natural – have double the risk of a cardiovascular event compared to other women, research has found.
Morning BP surge raises stroke risk in women
AN EXCESSIVE surge in morning blood pressure (BP) increases the risk of non-fatal stroke in women and could have implications for treatment and management, research suggests.
OSA in elderly raises CV death risk
ELDERLY people with untreated severe obstructive sleep apnoea (OSA) are at a higher risk of dying from stroke or heart failure, a prospective study shows.
Early warfarin resumption cuts patient mortality
RESUMING warfarin within 90 days of suffering a gastrointestinal (GI) bleed is associated with reduced risk of thrombosis and death and outweighs the risk of another bleed, research suggests.
Meta-analysis questions omega-3s for prevention
FISH oil supplementation may not help prevent myocardial infarction and stroke, according to a meta-analysis covering more than 20 years of research.
Patients with minor stroke at higher risk of disability
PATIENTS who have had a transient ischaemic attack (TIA) or minor stroke – many of whom are untreated – are at significant risk of disability, a study shows.
Being type A and stressed can bring on stroke
CHRONIC stress lasting longer than six months and type A personality traits are linked to an increased risk of stroke, a study suggests.
Low organ donation rate not linked to public health
THE hypothesis that Australia’s success in increasing public health and safety has hampered organ donation is a myth that does not adequately explain low donor rates, an analysis shows.
Stroke not prevented by vitamin C and E supplements
TAKING antioxidants such as vitamins C and E does not prevent stroke, but the potential benefits of vitamin D remain uncertain, according to an Australian expert.
Polypill powerful preventer of CVD
A four-component polypill has been found to reduce the blood pressure and LDL cholesterol levels of 50-year-olds without a history of cardiovascular disease to levels typical of 20-year-olds.
Statins’ CV prevention benefits both sexes
THE benefit of taking statins for secondary prevention has been confirmed for women as well as men in a meta-analysis.
Manipulation is all wrong for necks
CERVICAL spine manipulation should be abandoned for the treatment of mechanical neck pain, according to an Australian expert.
Drawing test strong predictor for post-stroke mortality
A SIMPLE line drawing test strongly predicts mortality following a first stroke in community-dwelling elderly men, a study shows.
Boehringer Ingelheim fined $125,000 for conduct breach
Boehringer Ingelheim has been fined $125,000 and ordered to shut down its ‘Vote Against Stroke’ website, which highlighted the government’s deferral of a PBS listing for Pradaxa, by Medicines Australia’s code of conduct complaints committee.
Wallabies' Lynagh survives rare stroke
DOCTORS have told Wallabies great Michael Lynagh he "dodged a cannonball" after surviving a rare and potentially lethal stroke that has severely limited his vision.
Many over-40s living with undiagnosed AF time bomb
AT LEAST 50,000 Australians aged 40 years or more may have atrial fibrillation (AF) without knowing it, new data suggest.
Half of TIA patients die within nine years
A TRANSIENT ischaemic attack (TIA) confers a relatively high mortality risk, with half of all patients dying within nine years, a major Australian study shows.
Anticoagulant under-prescribing may raise stroke risk in AF
MORTALITY rates from stroke in patients with atrial fibrillation (AF) are excessively high and a contributing factor may be the under-prescribing of anticoagulants, Australian experts say. Researchers from the University of New South Wales (UNSW) and the Ingham Institute looked at nearly 27,000 cases of ischaemic stroke occurring between 2000 and 2006 in the Program of Research Informing Stroke Management (PRISM) study, and found that a quarter were due to atrial fibrillation (AF). Patients with AF were twice as likely to die in hospital and had mortality rates of nearly 40% ...
Heightened neurological risk at high altitude
AIR travel can trigger neurological events, including among patients with a history of carotid stenosis, researchers warn. Their study analysed 77 neurological cases among passengers experiencing either an in-flight medical emergency, or one that occurred after landing, who were transported from a Madrid airport to hospital over almost two years. The patients were usually middle-aged men (76.6% male, mean age of 45.9 years). Symptom onset occurred during the flight in a minority of cases (41.3%). Most fell ill soon after their plane had landed. Just over one-half had a seizure (39 patients), almost one-quarter had ...
ABCD2 stroke prediction rule gets a boost
THE ABCD2 stroke clinical prediction rule is a useful tool in the management of transient ischaemic attacks (TIAs), despite under-predicting stroke risk in those at highest risk, a study suggests. Irish researchers performed a meta-analysis of 16 studies to determine the predictive value of the ABCD2 rule for stroke. They showed it correctly predicted strokes occurring seven days after a TIA, demonstrating 10% of the total strokes occur in the low-risk group, 51% in the moderate-risk group, and 40% in the high-risk group. However, a subgroup analysis including population-based studies of patients recruited from primary care ...
The rising rate of AF
A decade ago, atrial fibrillation was considered an emerging epidemic – has it now reached its peak? Kate Woods looks at the rise and rise of AF.
Study links low-dose NSAIDs to stroke risk in healthy population
EXPERT opinion remains divided on risks versus benefits of NSAIDs, after research shows even low doses may raise the risk of stroke in healthy individuals. The findings, building on earlier work linking NSAIDs to cardiovascular (CV) mortality, have prompted calls for diclofenac to be withdrawn. The Danish study, presented recently at the European Society of Cardiology congress, reviewed data from more than a million patients prescribed an NSAID. Diclofenac use increased the risk of stroke by 86%, while ibuprofen increased it by 28 per cent. There was a dose-dependent relationship with both drugs. David Henry, ...
Migraine with aura an independent CV death risk
MIGRAINE with aura can now be regarded as an independent risk factor for cardiovascular and all-cause mortality. An Icelandic study, including 18,725 middle-aged people, found migraineurs with aura had a 27% increased risk of cardiovascular-related death compared with non-migraineurs. After 26 years follow-up, they also had a 21% increased risk of all-cause mortality. There was no such increased risk among those with non-migraine headache or migraine without aura. The association remained after adjusting for other risk factors. “Migraine with aura was an independent risk factor for cardiovascular and all-cause mortality in both men and women, but ...
HRT patches prove safer than pills for stroke risk
THE RISK of stroke is reduced with the use of low-dose transdermal HRT patches compared to tablets in postmenopausal women, research shows. However, there is a slightly elevated risk for higher dose patches. A review of 70,000 medical records of UK women aged 50-79 years is the first to look at the difference in route of HRT administration in relation to stroke risk. Researchers evaluated more than 15,000 cases of stroke against HRT use, comparing patches with 50 µg oestrogen or less, and oral products containing 0.625 mg or less of equine oestrogen or less than ...
STRESS: a red flag for stroke?
It’s a common belief that stress can cause strokes. Leigh Parry looks at how much of a role it actually plays.
Fibrates: new lease of life in CV protection
MORE widespread use of fibrates has been advocated by Australian cardiologists who say there is now enough evidence of their benefit in the prevention of cardiovascular events in high-risk patients. While there had been inconsistent findings from previous studies, leading to some hesitation about their use, an Australian meta-analysis of 18 trials has found that using fibrates leads to a 10% reduction in major cardiovascular events and a 13% reduction in coronary events. Fibrates also reduced the risk of albuminuria progression by 14% and appeared to be safe, with no significant increase in drug-related adverse events. ...
High air pollution more harmful in stroke patients
STROKE patients living in areas with high concentrations of traffic-related pollution may have a lower chance of survival. UK researchers found that a 10 µg/m3 increase in particulate matter was associated with a 52% increased risk of mortality among 3320 patients who experienced a first-ever stroke. Each 10 µg/m3 increase in nitrogen dioxide was associated with a 28% higher mortality risk. “Patients who experienced stroke had reduced survival if they lived in areas with higher levels of outdoor air pollution,” the authors said. They suggested stroke may compromise respiratory function, rendering these patients more susceptible to respiratory ...
Easter Bunny delivers more than just eggs
THE Easter bunny may be delivering more than just a sweet treat this weekend with research finding consuming just six grams of chocolate per day may lower blood pressure and the risk of stroke and myocardial infarction (MI). German researchers examined the association between chocolate consumption and vascular disease based on food frequency questionnaires and blood pressure measurements in 19,357 participants aged 35 to 65 years and free of MI and stroke. After eight years follow-up, those with the highest chocolate consumption – an average of six grams of chocolate daily – had a 39% lower ...
Young stroke age ups risk to family
A parental history of stroke before the age of 65 gives offspring a significantly increased risk of stroke, researchers say. A US study of stroke incidence in 3443 people (mean age 48) revealed offspring with a parental history of early stroke were three times more likely to have had a stroke. The increase persisted after adjustment for conventional stroke risk factors, and was similar for both maternal and paternal stroke. “Parental stroke status might serve as a simple, clinically useful, aggregate measure of an individual’s hereditary propensity to stroke,” the authors said. An Australian expert ...
PVCs may be important marker of stroke risk
PREMATURE ventricular complexes (PVCs), commonly identified on ECG rhythm strips, may not be as benign as has been commonly believed, experts say. A US prospective study of 14,783 adults, aged 45 to 64 years, found those with frequent (four or more) PVCs had a two-fold increased risk of stroke, particularly non-carotid embolic stroke, up to 17 years later. In a sub-group of patients free of diabetes or hypertension, PVCs were also independently associated with a 70% greater risk of stroke. Associations were stronger for embolic rather than thrombotic stroke, meaning it was plausible that they were associated ...
Target CVD risk in migraine without aura
MIGRAINEURS without aura should join those who experience aura in being regularly checked for vascular risk factors, after more evidence shows a link between migraine and an increased risk of cardiovascular disease (CVD). A US case-control study involving 6102 migraineurs and 5243 patients without migraine, found those with self-reported migraines with and without aura had double the risk of myocardial infarction and a 50% greater risk of stroke than controls. They also had almost three times greater risk of claudication after five years, after adjusting for gender, age, disability, treatment and CVD risk factors. ...
Medication compliance poor after stroke
JUST two years after a stroke patients who survive are likely to be poorly compliant with critical medications, according to Swedish research. Among 21,077 survivors of stroke studied, the proportion of patients who continued regularly using their discharge medications rapidly declined. At the end of the study only 74% of patients were still taking antihypertensive agents, 64% continued with their antiplatelet therapies and just 45% were still taking warfarin. Professor Geoffrey Donnan, professor of neuroscience at the University of Melbourne, said the findings from the prospective study highlighted the need for coordinated care. Factors ...
Less pessimistic outlook predicts lower stroke risk
People with low levels of pessimism are at reduced risk of having a stroke, according to a European study. From a sample of 23,216 adults, aged 20 to 54 years, those in the lowest quartile of a pessimism scale had a 56% reduced incidence of stroke compared to those in the highest quintile, after seven years’ follow-up. The researchers adjusted for sociodemographic characteristics, cardiovascular risk factors, depression and ischaemic heart disease, and found those with lower pessimism still had a 48% reduced risk of stroke. “The precise mechanisms underlying the link between pessimism and stroke remain ...
Checkmate for warfarin?
Despite its limitations, warfarin has reigned supreme in the world of anticoagulation for half a century. But new competition could see its domination end. Chris Brooker reports. CONSPIRACY theorists claimed this colourless and odourless drug was once used in a plot to poison Stalin, while one of its first recipients, US President Dwight D. Eisenhower, was famously administered it following a myocardial infarction in 1955. Despite warfarin’s well-known limitations, no effective anticoagulant has been able to unseat its leading role in clot prophylaxis for over 50 years. But times are changing, and the drug, ...
Herpes zoster increases stroke risk
THE risk of stroke is substantially increased in the year after a herpes zoster attack, researchers have confirmed. Taiwanese researchers found that patients who had received treatment for herpes zoster were 31% more likely to have a stroke within the next year, when compared to controls and after adjusting for cardiovascular risk factors. Among patients with herpes zoster ophthalmicus, stroke risk was more than four-fold higher than in controls. The case-controlled study investigated the frequency and risk of stroke among 7760 patients, average age 47, who were treated for herpes zoster, compared to 23,280 randomly selected ...
Marker offers new approach to assessing CVD risk
LIPOPROTEIN(A) concentrations are being identified as an independent marker for risk of coronary heart disease (CHD), ischaemic stroke and non-vascular mortality, and may take on an important diagnostic role in the future, experts say. A collaboration of international lipids experts has reviewed data from 36 cohort and case-control studies, and concluded lipoprotein(a) (Lp[a]) was continuously, independently and modestly associated with risk of CHD and stroke. The review, including data from 126,334 patients, found a 13% greater risk of CHD per 3.5-fold higher than usual Lp(a) concentration, after adjustment for age, sex, lipids and other conventional risk factors, ...
Antihypertensive monitoring challenged
CURRENT recommendations for regular monitoring of patients receiving antihypertensive drugs have been challenged by new Australian research. An international randomised controlled trial of 1709 patients with a history of stroke or transient ischaemic attack who were taking antihypertensives found regular checks of their blood pressure did not accurately reveal their response to treatment. Participants' blood pressure was recorded at diagnosis and at regular intervals for 33 months. The researchers estimated that for every true 10 or 20 mmHg increase in systolic blood pressure over a six-month period, there would be six or 200 patients respectively with ...
A new approach with statins
A controversial new study could pave the way for a very different approach to cardiovascular prevention using statins. Kate Woods reports. IT was the big news story of the 2008 American Heart Association annual scientific session held in New Orleans last November. Upon its release, experts around the world said it would have a significant impact on the practice of cardiology, and become a topic that would be discussed at length by guideline and policy makers over the next two to three years. At least one pharmaceutical company has admitted it is being used ...
Program targets stroke prevention in CVD
LOW-DOSE aspirin should be routinely used for primary stroke prevention, according to a new campaign targeting GPs. The program, developed by the National Prescribing Service (NPS), recommends low-dose aspirin be considered for all patients at high cardiovascular risk. Professor Graeme Hankey, head of the stroke unit at Royal Perth Hospital, said GPs should consider aspirin in patients with a five-year absolute cardiovascular risk of greater than 10% based on the New Zealand Guidelines Group Cardiovascular Risk Calculator. “If the calculator gives them a score greater than 10% over five years, [doctors] should think perhaps the benefit ...
Coffee reduces stroke risk
WOMEN who are regular coffee drinkers have a modestly lower risk of stroke, a 24-year prospective study has found. US researchers assessed the coffee intake of more than 83,000 women every two to four years and found long-term consumption of more than two cups per day was associated with a 20% reduction in the risk of stroke. Women who drank five to seven cups per week had a 12% lower risk, but there was no reduction among less regular drinkers. Decaffeinated coffee was also associated with a trend toward a lower risk of stroke, the authors ...
Doubts over stroke prevention surgery
YOUNGER Australians who have had a stroke could be undergoing a surgical procedure for which there is a lack of evidence of efficacy or risk. The procedure – percutaneous closure of patent foramen ovale (PFO)/atrial septal defects (ASD) – involves closing a congenital defect in the atrial septum using a small device implanted via the femoral vein. A US study showed a 58-fold increase in percutaneous PFO/ASD closure procedures from 1998 to 2004, and MO has spoken to Australian experts who confirmed the procedure had also been increasingly used here despite the lack of evidence. ...
Jury out on best option to prevent second stroke
THERE is little difference between an aspirin/dipyridamole combination or clopidogrel alone for prevention of a second stroke, a large international study has found. The 35-country Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) Trial, funded by Boehringer Ingelheim, randomised 20,332 elderly patients with recent strokes to receive either 25 mg of aspirin plus 200 mg of extended-release dipyridamole twice daily or 75 mg of clopidogrel alone per day. Patients in both cohorts were also randomised to receive telmisartan or placebo. After an average of 2.5 years, both groups had a similar risk of recurrent stroke – ...
Vitamins C and E are not cardioprotective in men
VITAMIN C and E supplements are not effective in preventing cardiovascular events in middle-aged or older men, new data has revealed. The findings from the Men’s Health Study also showed the use of vitamin E supplements appeared to carry a greater risk of stroke. While some studies had pointed to both vitamins potentially having a cardioprotective role, prospective cohort studies had yielded conflicting results about their benefits. New data from the Physician’s Health Study II, a double-blind, placebo-controlled trial of 14,641 male physicians older than 50 years (mean age 64.3 years) found no difference between a ...
Fabry’s disease a stroke risk in adult patients
FABRY’S disease – a lysosomal storage disorder – is an important risk factor for stroke in younger adults, experts say. German data presented at the Stroke 2008 Conference in Sydney identified Fabry’s disease in 5% of 721 stroke patients aged 55 or younger, using enzyme analysis in men and women. Lead researcher Professor William Wilcox, from the Medical Genetics Institute at Cedars-Sinai Medical Center in California, said: “Perhaps all adult patients with unexplained stroke under 55 should be screened for Fabry’s disease.” He said stroke patients with Fabry’s disease were often characterised by endothelial dysfunction, inflammatory ...
Heart risks double with AMD
ELDERLY people with age-related macular degeneration (AMD) in its early stage have double the risk of dying from heart attack or stroke over the next decade, compared to those without it. Data from nearly 2000 participants in the Blue Mountains Eye Study, aged 49 to 75 years, suggested that the condition independently predicted cardiovascular events ( Br J Ophthalmol ; 2008, in press ). “A potential link between AMD and vascular disease would have important therapeutic implications given current concern that some intravitreal anti-vascular endothelial growth factor treatments for AMD could increase stroke risk,” they wrote. ...