Modifiable stroke risks still rising across all ages, races

Most - not all, but most - strokes are preventable. Experts have been know for years that risk factors include high blood pressure, smoking and high cholesterol. All addressable issues. Yet, as NPR reported not long ago, modifiable stroke risks are still rising across all ages and races:

For years, doctors have been warning us that high cholesterol, cigarette smoking, illegal drug use and diabetes increase our chances of having a potentially fatal stroke.

And yet, most of the stroke patients showing up at hospitals from 2004 to 2014 had one or more of these risk factors. And the numbers of people at risk in this way tended to grow among all age groups and ethnicities in that time period. 

Men are seeing a decline in stroke risk - but women?

You might have seen postings about the disturbing numbers about younger people having strokes. Now, while stroke risk is declining among some groups, a recent study suggests that stroke risk is declining in men but not women:

The incidence of stroke has declined in recent years, but only in men.

Researchers studied stroke incidence in four periods from 1993 to 2010 in five counties in Ohio and Kentucky. There were 7,710 strokes all together, 57.2 percent of them in women. ...

No one knows why there has been no improvement in women, but the lead author, Dr. Tracy E. Madsen, an assistant professor of emergency medicine at Brown, said that some risk factors have a stronger effect in women than in men. Risk factors for stroke include high blood pressure, heart disease, diabetes and smoking.

Undiagnosed and untreated - what's your blood pressure?

Last week, the focus was global hypertension problems. Now, in a North American study, we learn that high blood pressure is often undiagnosed, untreated:

For the study, the researchers measured the blood pressure of almost 1,100 volunteers. The measurements were taken at mobile clinics that the researchers had set up at shopping malls, workplaces, hospitals and community centers in a large city.

The study revealed that 50 percent of the participants were unaware they had high blood pressure. Of these people, 2 percent were at very high risk for health complications.

The findings were published online Jan. 5 in the American Journal of Hypertension.

"What is particularly significant about this study is that a surprisingly large number of participants exhibited some type of hypertensive urgency or emergency," study author Dr. Grant Pierce said in a journal news release. Pierce is executive director of research at St. Boniface Hospital in Winnipeg.

Most of the people with high blood pressure weren't being treated even if they had been diagnosed. The study authors suggested that either these people didn't fully understand their condition, or they didn't understand the health consequences associated with high blood pressure.

High blood pressure is the leading cause of strokes. Taking it seriously might save a life.

The world is experiencing a high blood pressure increase

High blood pressure - hypertension - is the leading risk factor for strokes.

So the news is a little frightening - high blood pressure is increasing worldwide:

"There are almost 900 million people in the world with hypertension, and there are almost 3.5 billion people with elevated blood pressure that doesn't quite meet the definition of hypertension," said study lead author Christopher Murray. He directs the University of Washington's Institute for Health Metrics and Evaluation in Seattle.

"Blood pressure is the leading cause of premature death and disability in the world," Murray said.

Blood pressure is made up of two numbers. The top number, called systolic pressure, measures the pressure in the arteries when blood is being pumped from the heart. The bottom number, the diastolic pressure, measures pressure between heartbeats. Blood pressure is expressed in millimeters of mercury (mm Hg).

The study authors said that even systolic blood pressure within what is considered a normal range -- less than 120/80 mm Hg, according to the American Heart Association -- can increase the risk of heart attack and stroke.

It's important to pay attention to your blood pressure and if needed, work with your health professionals to control it.

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

America's Stroke Belt and stroke risk factors

Do you live in the "Stroke Belt," or generally the southern/southeastern United States, plus Indiana?

Stroke risk factors - which we've talked about lately, are a big part of the problem. And strokes can hit young people, too, especially in the Stroke Belt. I ran across this story from Memphis about an unlikely stroke victim:

She blacked out. When she came around, her left side was going numb.

Politics aside, cigarette taxes are linked to smoking decline

There's a lot of politics in taxes. So I'll leave lawmakers or voters to decide on cigarette taxes. However, if somehow, someday the tobacco industry grinds to a complete stop, I'll be OK with that.

Regardless of politics, though, check out how smoking declines as cigarette taxes rise:

The number of cigarette smokers in the United States has dropped by 8.5 million since 2005 — and that fall could be accelerated by a tobacco tax just passed in California.

Stroke risk factors that need a solution

If you've read much of this blog, you've seen items about smoking, diet and other stroke risk factors. Click here to read a compilation.

But are you always in complete control of those risk factors? Or does just living in a poor neighborhood up stroke risk?:

Women and men of all races in the poorest neighborhoods were more likely to suffer a stroke than those in the richer neighborhoods. This held true even after the researchers adjusted for other factors such as age, race, sex and region of the country.

Inhaling secondhand smoke? It's linked to higher risk of stroke

Here's yet another reason to stop smoking (or better yet, never start). Researchers found that secondhand smoke is linked to higher risk of stroke:

Researchers found that never-smokers who had a stroke were nearly 50 percent more likely to be exposed to secondhand smoke at home than people who had never had a stroke.

During the study, stroke survivors exposed to secondhand smoke were also more likely to die from any cause compared to those without secondhand smoke exposure.

Sleep - reducing stroke risk, boosting recovery

I know people who wish they didn't have to sleep so much. Sometimes I wish that, thinking how much more I can accomplish.

Then you read stories like this, linking sleep problems to stroke risk, recovery:

In addition, sleep problems can affect recovery from a stroke, according to the report.

Myth No. 3: Strokes are just for elderly people

I was 39. And I'm not the only one, not by far - scores of people younger than me have had strokes. Thus another installment of the occasional series about myths about strokes.

Strokes do not recognize your age. It can happen to the young or the old. Check out the chilling facts about how hospitalizations are rising quickly among younger adults:

Because strokes are most often associated with old age, symptoms in younger adults are often overlooked, according to patients, advocates and physicians. And their need for rehabilitation – to return to active lives as parents and employees, for instance – can be underestimated.

'Mind your risks' especially important for high-risk populations

The best way to "treat" a stroke is to prevent it. This is from someone who had one.

Of course, not every stroke is preventable. Mine was a cryptogenic stroke. But the great majority are preventable, and here's an item about efforts in the area of racial disparities in stroke:

"The prevalence of hypertension is higher in blacks, but its impact is even greater in the black population. An increase of 10mmHg in blood pressure is associated with an 8 percent increase in stroke risk among whites but a 24 percent increase in stroke risk in blacks," said Dr. Walter Koroshetz, director of NINDS.

Blood pressure - finding patterns might help prevent strokes later

High blood pressure, as we know, is the leading cause of strokes.

Now, it seems, reviewing patterns in a person's blood pressure over time - in years - might find clues about predicting stroke risk:

For this new study, Portegies and her colleagues collected 20 years of data on the systolic blood pressure (the top number in a blood pressure reading) of more than 6,700 Dutch adults. Participants were ages 55 to 106 and living in a suburb of Rotterdam.

Stroke stats can be confusing - but many strokes can be prevented

News about strokes in the United States is mixed bag these days. Fewer hospitalizations. Fewer total rates. Higher rates among young people. Increases in some stroke risk factors.

And not all of those issues are answered - just speculation about, for example, why young people are seeing an increase in strokes.

One obvious item is stroke prevention, especially for those changeable lifestyle behaviors that could really reduce risk. Check out this piece about different populations and stroke prevention:

Call it "mini" but don't call it unimportant

Just because something is called "mini" doesn't mean it's not big.

A mini-stroke - or transient ischemic attack, TIA for short - is often a sign for a devastating stroke to follow. So take it seriously.

I posted a similar item last week, but it's worth repeating - quick, aggressive treatment for TIAs could slash major stroke risk by 50 percent:

According to the researchers, sending a person to the hospital after a “mini-stroke,” even if the muscle weakness or slurring of speech lasted a mere few seconds, could reduce the risk of major strokes by as much as 50 percent. TIAs, after all, are oftentimes a sign that a more serious, possibly fatal stroke may be coming in days, or even a few hours.

Know someone who is ... Caregiver? Spouse? Stressed? That person is not alone

Stress is your enemy.

Photo from bottled_void
via Flickr

Stress is especially an enemy for caregivers - and those people are often prime targets for stress.

The needs of caregivers can be woefully ignored, including their own health care, which includes mental care. You should take note from this story on how stressed spouse caregivers race a higher stroke risk:

Spousal caregivers who reported being under moderate or severe strain had a 5.1% rate of incident stroke, compared with 2.6% among propensity-matched people who were not caregivers ... , Sindhu Lakkur, PhD, of the University of Alabama at Birmingham, and colleagues found. ...

The researchers suggested there could be a public health implication for targeting stroke prevention efforts to this higher risk group of struggling spouse caregivers. Exactly how this might be done needs further study, Lakkur told MedPage Today.

Raise your glass for a toast ... or not ... or do it ... or not ...

Way before people had blogs, we went back and forth about whether drinking is bad for you, or not bad for you. Then it was decided that a little red wine is good for you.

But now, a study indicates, stroke risk goes higher after drinking:

Drinking alcohol was linked to an immediate increase in heart attack and stroke risk in all drinkers, but moderate drinkers seemed to experience some protective cardiovascular benefits within 24 hours of imbibing, according to a systematic review and dose-response meta-analysis.

On the other hand, heavy drinkers saw a sustained elevated risk, reported Elizabeth Mostofsky, ScD, of Harvard T.H. Chan School of Public Health, and colleagues. The study was published in Circulation and presented at the American Heart Association's Epidemiology and Prevention/Lifestyle 2016 Scientific Sessions in Phoenix.

Latest study leans toward an answer to a stroke risk factor

A still from the video of my PFO being closed
click here to view the video

We've seen a lot of information bounced back and forth about the efficacy of closing a patent foramen ovale, or a hole between the two upper heart chambers.

Now, read about a study showing that the closure may prevent further patent foramen ovale-related strokes:

"PFO-related cryptogenic strokes tend to be larger and more superficial, and PFO-unrelated cryptogenic strokes tend to be deeper and smaller, so in the medical management group we saw more larger and superficial strokes than in the device group, suggesting there were still PFO strokes in the medical management group," Thaler told MedPage Today. "So it all makes sense even though the overall trial was negative."

What are your blood pressure numbers? And what number seems like a good idea?

Still more about the quest for blood pressure target numbers- this time, how that the gray area for high blood pressure can make risky targets of women and minorities:

Stroke risk is lower for healthy older adults with blood pressure under 140 mm Hg than in the disputed 140 to 149 mm Hg range, particularly for minorities and women, according to a cohort study.

In the prospective population-based Northern Manhattan Study cohort of 1,750 people 60 and older, and free of stroke, diabetes, and chronic kidney disease (CKD) at baseline, the adjusted odds of incident stroke over a median 13 years of annual follow-up were a significant 70% higher with a systolic blood pressure of 140 to 149 mm Hg than with lower blood pressures.

Good advice - find the balance between treatment risks and benefits

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

Now, as Paul Harvey used to say, the rest of the story.

I've posted quite a bit about high blood pressure as a stroke risk. It's the leading cause of strokes.

A wise doctor, as part of taking care of my aging mother a few years ago, described health decisions about her as a balancing act. Take this medication, and it might affect that ailment, which might affect other medication, and so on and so on. Truer words were never spoken.

Now, here's some thoughts to consider about high blood pressure, new targets and possible medication side affects, in an article stating that new blood pressure guidelines a danger to patients:

Aging gracefully - or at least while sleeping - might be important

Sleep well?

I must admit that the older I get, the more often I wake up in the middle of the night. Thankfully, I usually go right back to sleep after a small excursion.

Still, measuring sleep quality, especially for seniors, might important information in managing one's stroke risk. Recent research suggests that for seniors, poor sleep may mean higher stroke risk:

Researchers examined the autopsied brains of 315 people, average age 90, who had undergone at least one full week of sleep quality assessment before their death. Twenty-nine percent of them had suffered a stroke, and 61 percent had moderate-to-severe damage to blood vessels in the brain.