Stroke

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REVIEW our Selected Stroke Articles in 2006. Stay informed and updated!

Stroke

NIH - Medical Encyclopedia: Stroke

"The goal is to get the person to the emergency room immediately, determine if he or she is having a bleeding stroke or a stroke from a blood clot, and start therapy -- all within 3 hours of when the stroke began."

Highlighted Article

Transient Ischemic Attack: A Dangerous Harbinger and an Opportunity to Intervene. (Semin Neurol. 2005)

"Transient ischemic attack (TIA) and ischemic stroke are both characterized by sudden onset of neurological symptoms due to focal cerebral ischemia, but they are distinguished by the duration of neurological symptoms, with TIA traditionally defined by resolution of symptoms within 24 hours and stroke reserved for symptoms of longer duration. ... The short-term risk of ischemic stroke after TIA is very high ..."

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Stroke

Risk Reduction

NEWS:

Folic acid 'reduces stroke risks' "Folate is a water-soluble B vitamin that occurs naturally in food. Folic acid is the synthetic form of folate that is found in supplements and added to fortified foods Both folic acid and vitamin B12 are essential for good health and good levels can be achieved by eating a healthy, balanced diet. … Dr Peter Coleman of The Stroke Association cautioned: 'Supplementing the diet with folic acid may reduce the risk of stroke in certain individuals, but is not suitable for everybody, and could actually increase the risk of cardiovascular disease in some people.' 'We urge people to consult with their doctors before taking any supplements or medication with a view to reducing their risk of stroke.' "

Good physical functioning tied to lower stroke risk "Middle-aged and older adults who manage to stay agile may be less likely to suffer a stroke than their less-nimble peers, researchers reported Monday. In a study of more than 13,000 men and women, British researchers found that those who reported good physical functioning at the study's start -- having little problem climbing stairs or carrying groceries, for instance -- were less likely to have a stroke over the next seven years."

Treating Sleep Apnea Could Lower Stroke Risk "Some people with a moderate to severe form of the nighttime breathing disorder sleep apnea may be at an increased risk of stroke, a Japanese study finds. Treating their sleep apnea might help lower that risk, however."

ARTICLES:

Transient Ischemic Attack Prevention

JOURNAL ARTICLES:

Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. (Lancet. 2007) "INTERPRETATION: Our findings indicate that folic acid supplementation can effectively reduce the risk of stroke in primary prevention."

Inhibition of the Renin-Angiotensin System and the Prevention of Stroke. (Am J Cardiovasc Drugs. 2007) "BP is the most important determinant of the risk of stroke. A small reduction in BP results in a substantial reduction of both ischemic and hemorrhagic stroke. Any of the commonly used antihypertensive drugs lower the incidence of stroke, with larger reductions in BP resulting in larger reductions in risk. Experimental evidence has linked the renin-angiotensin system (RAS) to the development and progression of cerebrovascular disease. Inhibition of the RAS has beneficial cerebrovascular effects and may reduce the risk of stroke in a manner possibly independent from the alterations of BP. … Hypertension is not only the most important risk factor for stroke, but is also closely correlated with cognitive decline and dementia. Therefore, prevention of cognitive decline or even improvement of slightly diminished brain function should be an important goal for antihypertensive treatment in the future. Some clinical data suggest advantages for ACE inhibitors, ARBs, and calcium channel antagonists. Currently, however, the existing data are not sufficient for clinical recommendations."

Prevention of Recurrent Ischemic Stroke (Am Fam Physician 2007) "Risk factors such as hypertension, diabetes, and hypercholesterolemia should be evaluated during each office visit. Attention should be given to lifestyle modification including management of obesity, smoking cessation, reduction in alcohol consumption, and promotion of physical activity. The choice of an antiplatelet agent (e.g., aspirin, ticlopidine, clopidogrel, dipyridamole) or the anticoagulant warfarin is based on the safety, tolerability, effectiveness, and price of each agent."

Prevention of Stroke in Patients with Hypertension (The American Journal of Cardiology 2007) "Optimal treatment should provide powerful 24-hour blood pressure control, including during the early morning hours when the risk of stroke is highest. In addition, antihypertensive therapies selected should have positive blood pressure–independent effects on stroke risk. In contrast to angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers (ARBs) provide consistent benefits in stroke protection beyond blood pressure lowering."

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