Less education and smoking: Deadly combination?

There's  been lots of studies and stories about disparities among more vulnerable populations. People with less education are no exception, especially those who smoke. One recent study found that less educated smokers are at greatest risk for stroke:

"The combined effect of low educational level and smoking on the risk of stroke is the most surprising finding of our paper," said study author Helene Nordahl, an epidemiologist in the department of public health at the University of Copenhagen.

She added that reducing smoking among those with the least education could potentially reduce strokes more than targeting smoking in those with the most schooling.

Although the study included Danish participants, Nordahl believes her findings are applicable to other countries.

"Since the most disadvantaged groups are often exposed to a wide number of stroke risk factors, it seems plausible that these people are at increased risk of stroke, not only in Denmark but also in the U.S.," Nordahl said.

The second paragraph of this excerpt hits home - for public health education, it's important connect with the right people to reduce stroke risk.

And EVERYONE is important...

Time for younger set to start taking care

Once again, we're seeing more concerns about young people and stroke risk. for older people, the rate of stroke is declining. For people younger, there seems to be trouble. Read this article how stroke incidence is down and survival up -- for some:

These stroke incidence data appear to reflect both positive and negative trends in stroke prevention and treatment over the last few decades, Koton said.

Photo from U.S. Centers for
Disease Control and Prevention

On the plus side, increased use of statins and hypertension medications and a dramatic decline in smoking may largely explain the lower stroke rate among people over the age of 65, while the rise in obesity and diabetes in younger adults could explain the lack of progress in reducing stroke incidence in younger adults, Koton told MedPage Today.

"More younger adults are obese, and when obesity increases so does hypertension and diabetes," she said. "Hypertension is the main risk factor for stroke. I think this is a warning sign for us to take these risk factors as seriously in younger people as we do in older people."

Yes - time for ALL ages to take stroke risk factors SERIOUSLY.

Mental decline concern? Time to take action

A scary thought: Mental decline often precedes a stroke, study finds:

"Low cognitive function is generally associated with poor neurological health and brain function. Worsening of neurological health can lead to several health problems with stroke being one of them," he explained.

Photo from the National
Institute on Aging

Previous research has shown that poor cardiovascular health can increase the risk of mental decline, but the researchers say this is the first study to show that mental decline can increase the risk of stroke.

The findings suggest that assessing seniors' memory and thinking skills could help identify those at risk for stroke, though the study only found an association between memory and stroke risk, without proving cause-and-effect.

I don't like to post scary stories that show no hope. And in the last paragraph in the above quite, there's some hope. It shows a need for "help identify those at risk for stroke." Identify those at risk, and you've got a chance to take some preventive action.

So, scary thought, but a chance to take action.

'Turns my darkness into light'

You, Lord, are my lamp; the Lord turns my darkness into light.

-2 Samuel 22:29

As summer starts its final weeks, days are getting shorter. In several more weeks, that'll be even more pronounced.

The Old Testament's David had his dark days, too. He was hunted by Saul. Had his own failings.

But this verse is part of David's praise to God, acknowledging God's strength and perfection. You can read the entire chapter here.

When dark days come, God is present to turn your darkness into light.

Young stroke outcomes: A key reason for stroke prevention

This is one reason why stroke prevention is so important: Strokes subtract years from lives. Tragically, that's especially critical among the younger stroke survivors (mine was at 39).

Read about recent research showing that mortality is high after an early stroke:

The mortality rate of people who survived at least a month after having a stroke at age 15 to 49 was 15.7% over a mean 10 years of follow-up and 23.0% cumulatively with up to 17 years of follow-up, Karoliina Aarnio, MD, of the Helsinki University Central Hospital, and colleagues found.

That rate was seven-fold higher than that of the age- and sex-matched general population, they reported in the September issue of Stroke. ...

"The high mortality rates and the striking impact of recurrent stroke on the risk of death should lead to development of more robust primary and secondary prevention strategies for young patients with stroke," they argued.

Reduce disability risks - get help immediately for stroke patients

Among adults in the United States, stroke is the leading cause of permanent disability. And too many times, those disabilities came about because of delay in treatment.

Even more research makes it even clearer - know the stroke signs and get help. Immediately. Share this information with family, friends, loved ones, colleagues, acquaintances - anyone and everyone.

British researchers found (again!) that speedy delivery of a clot-busting drug helps stroke patients avoid disability:

Prompt treatment with tissue plasminogen activator (tPA, also known as alteplase) "is a very effective means of limiting the degree of disability in stroke patients," study co-author Dr. Jonathan Emberson, of University of Oxford in the U.K., said in a news release from the journal The Lancet.

The study, published in the journal on Aug. 5, also reinforces the idea that the quicker that patients can get tPA, the better.

One U.S. expert agreed. "The analysis reiterates the importance of patients going to the ER immediately at the time of developing acute neurological symptoms that could be due to a stroke," said Dr. Rafael Alexander Ortiz, director of interventional neuroradiology and stroke at Lenox Hill Hospital in New York City.

Simple pulse check: Potential tool for stroke survivor care

I've seen a lot of needles, scalpels, and other tools that are at least somewhat invasive. Most of them did a lot more good than harm, and if I had to do it all over, I'd probably say yes again in the great majority of the time.

Indeed, today, I had a knee injection (virtually painless) that made good sense in my medical care.

Still, "noninvasive" is a term I like, so I was interested in hearing that a simple routine pulse check may detect the possibility of a second stroke, study says:

"Screening pulse is the method of choice for checking for irregular heartbeat for people over age 65 who have never had a stroke. Our study shows it may be a safe, effective, noninvasive and easy way to identify people who might need more thorough monitoring to prevent a second stroke," said study author Dr. Bernd Kallmunzer, of Erlangen University in Germany.

The study included more than 250 people who survived an ischemic stroke (blocked blood flow to the brain). Either the patients or their relatives were taught how to monitor the pulse to detect an irregular heartbeat.

Pulse checks taken by patients and relatives were nearly as accurate as those taken by health care workers, according to the study published online July 23 in the journal Neurology.