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stroke hypertension

Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are widely used for prevention of stroke secondary to nonvalvular atrial fibrillation (NVAF). Increased use of NOACs is partially a result of simplified regimens compared with warfarin, which has been associated with poor adherence and persistence to therapy. Few studies have assessed adherence to NOACs, especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To evaluate adherence to NOACs in a cohort of newly diagnosed NVAF patients who are commercially insured...
November 2016: Journal of Managed Care & Specialty Pharmacy
Masateru Kawakubo, Hiroshi Akamine, Yuzo Yamasaki, Atsushi Takemura, Kohtaro Abe, Kazuya Hosokawa, Junji Morishita, Michinobu Nagao
In this study, three-dimensional phase contrast magnetic resonance imaging (3D-PC MRI), a novel technique, was validated to assess pulmonary artery (PA) flow in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The MR data of PAs from 3D-PC and two-dimensional PC (2D-PC) from before and after treatment for 3 patients with CTEPH were retrospectively analyzed. Additionally, 3D- and 2D-PC MR scans of PA were performed in 5 healthy volunteers. Correlation of stroke volumes (SVs) obtained by 3D-PC and 2D-PC was analyzed using Pearson's correlation coefficients...
October 25, 2016: Radiological Physics and Technology
Diogo C Haussen, Ashutosh Jadhav, Leticia C Rebello, Samir Belagaje, Aaron Anderson, Tudor Jovin, Amin Aghaebrahim, Deepak Gulati, Bryan Wells, Michael Frankel, Raul G Nogueira
BACKGROUND AND PURPOSE: Craniocervical fibromuscular dysplasia (FMD) is associated with dissections and with S-shaped curves in the internal carotid artery (ICA). We evaluated the occurrence of S-curves in patients presenting with acute strokes due to ICA steno-occlusive dissections. METHODS: This was a retrospective review of the interventional databases of two academic tertiary-care institutions. The presence of ICA S-shaped curves, C-shaped curves, 360-degree loops, as well as classic FMD and atherosclerotic changes at the ICA bulb and curve/loop was determined...
September 2016: Interventional Neurology
Chirag Bavishi, Sripal Bangalore, Franz H Messerli
The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in the pathogenesis of hypertension (HTN). Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are first line anti-HTN drug classes that are potent, effective and largely safe. Direct renin inhibitors (DRIs) have shown similar blood pressure (BP) reduction but more side effects. The efficacy of ACEIs and ARBs (for cardiovascular, cerebrovascular and renal protection) has been promoted to extend beyond what could be explained by BP reduction alone...
October 21, 2016: Progress in Cardiovascular Diseases
Eliza C Miller, Hajere J Gatollari, Gloria Too, Amelia K Boehme, Lisa Leffert, Mitchell S V Elkind, Joshua Z Willey
Importance: Older age is associated with increased risk of pregnancy-associated stroke (PAS). Data are limited on age-specific incidence ratios of PAS compared with stroke risk in nonpregnant women. Objectives: To assess the risk of stroke by age group in pregnant and postpartum women compared with their nonpregnant contemporaries and to compare risk factors across age groups in the exposed (pregnant/postpartum) and unexposed (nonpregnant) populations. Design, Setting, and Participants: International Classification of Diseases, Ninth Revision, billing codes from the calendar year 2003-2012 New York State Department of Health inpatient database and population data were used to identify all women aged 12 to 55 years with cerebrovascular events, including transient ischemic attack, ischemic and hemorrhagic stroke, cerebral venous thrombosis, and nonspecified PAS...
October 24, 2016: JAMA Neurology
Elena V Galitsyna, Margarita A Sazonova, Tatiana P Shkurat, Natalya A Demakova, Alexsandra A Melnichenko, Vasily V Sinyov, Anastasia I Ryzhkova, Konstantin Y Mitrofanov, Andrey V Zhelankin, Igor A Sobenin, Alexander N Orekhov
The present article considers chronic diseases of non-inflammatory genesis, the reasons of which may be mitochondrial dysfunctions. Among them are: coronary heart disease (CHD), hypertension, cardiomyopathy, cerebrovascular accidents and type 2 diabetes mellitus (T2D). Very often, in the long course of the disease, complications may occur, leading to myocardial infarction or ischemic stroke and as a result, death. The main cause of mitochondrial dysfunction are point mitochondrial genome mutations. During the analysis of the literature, data showing the association of the mitochondrial genome mutations with the above diseases were revealed...
October 18, 2016: Current Pharmaceutical Design
Anne H Calhoun
Unnecessary confusion still surrounds the use of combined hormonal contraceptives (CHCs) in the setting of migraine with aura (MwA). Clearing this confusion is a key issue for headache specialists, since most women with migraine have menstrual-related migraine (MRM), and some CHCs can prevent this particularly severe migraine. Their use, however, is still restricted by current guidelines due to concerns of increased stroke risk - concerns that originated over half a century ago in the era of high dose contraceptives...
October 24, 2016: Headache
Haruki Tokida, Yuhei Kanaya, Yutaka Shimoe, Shigeru Yamori, Koichi Tagawa, Masaru Kuriyama
We report a case of a 55-year-old man who developed acute-onset narrowing of his visual field. He showed right homonymous hemianopsia without any other neurological symptoms and signs. Brain CT and MRI showed localized hemorrhage (about 1.6 ml) in the left lateral geniculate body (LGB). A cerebral angiography showed no vascular anomalies of cerebral vessels, and the left anterior choroidal artery and left lateral posterior choroidal artery could be visualized well. He had hypertension, polycythemia and dyslipidemia and was a habitual smoker and an alcoholic...
October 21, 2016: Rinshō Shinkeigaku, Clinical Neurology
Tarun Saxena, Sanjay Patidar, Manjari Saxena
BACKGROUND: Pathophysiology of essential hypertension remains obscure. Correlation among ventricular ejection force, sympathetic activity, and hypertension is less clearly narrated in hypertensive subjects. AIMS AND OBJECTIVES: To assess correlation among ventricular ejection force, sympathetic activity, and hypertension in hypertensive subjects, and to be compared with normotensive subjects. METHODS: This is a case-control study to assess left ventricular ejection force (LVEF) and sympathetic skin response, in normotensive (group 1; control), and hypertensive subjects (group 2; cases)...
September 2016: Indian Heart Journal
C Narasimhan, Jagmohan Singh Verma, A G Ravi Kishore, Balbir Singh, Sameer Dani, Kamaldeep Chawala, Azizul Haque, Aftab Khan, Mohan Nair, Amit Vora, V Rajasekhar, Joy M Thomas, Anoop Gupta, Ajay Naik, V S Prakash, Lisa Naditch, P Gabriel Steg
BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia with high risk for many cardiovascular (CV) complications. Adherence to recommended management guidelines is important to avoid complications. In India, there is little knowledge on how AF is managed in real world. METHODS: This is a cross-sectional study of patients in India enrolled in RealiseAF survey between February 2010 and March 2010 with a diagnosis of AF within the last 12 months...
September 2016: Indian Heart Journal
Nizal Sarrafzadegan, Mojgan Gharipour, Masoumeh Sadeghi, Pouya Nezafati, Mohammad Talaie, Shahram Oveisgharan, Fatemeh Nouri, Alireza Khosravi
BACKGROUND: Metabolic syndrome (MetS) is recently proposed as a predictor for the occurrence of vascular defects causing ischemic stroke. However, details on the association of MetS with stroke are scare in our region. The present study aimed to assess the predictive value of MetS and its components for stoke among the Iranian population. METHODS: A longitudinal population-based study was conducted on adults aged 35 years or older who were living in 3 districts in central part of Iran and followed for 10 years...
October 18, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Mahnaz Ashoorkhani, Ali Bozorgi, Reza Majdzadeh, Hamed Hosseini, Ali Yoonessi, Ali Ramezankhani, Hassan Eftekhar
BACKGROUND: Hypertension is one of the most important and well-known risk factors for cardiovascular diseases. Unfortunately, in spite of effective treatments, adherence to the regular use of drugs and other nondrug treatments, such as lifestyle improvement, is often poor. This study evaluates the effectiveness of an educational, supportive intervention - in the form of a Blood Pressure Management Application (BPMAP) - on self-management in patients with primary hypertension on controlling the determinant factors of hypertension, and on adherence to treatment...
October 21, 2016: Trials
Alessandro Mantovani, Lucia Mingolla, Riccardo Rigolon, Isabella Pichiri, Valentina Cavalieri, Giacomo Zoppini, Giuseppe Lippi, Enzo Bonora, Giovanni Targher
BACKGROUND: Recent studies suggested that nonalcoholic fatty liver disease (NAFLD) is associated with an increased prevalence of cardiovascular disease (CVD) in type 1 diabetes. We assessed whether NAFLD also predicts the risk of incident CVD events in type 1 diabetic adults. METHODS: We studied a retrospective cohort of 286 type 1 diabetic outpatients (mean age 43±14years; median duration of diabetes 17 [10-30] years) without secondary causes of chronic liver diseases, who were followed for a mean period of 5...
October 17, 2016: International Journal of Cardiology
A Muruganathan, Mangesh Tiwaskar
While the incidence and prevalence of stroke is gradually decreasing in the western world, a parallel increase is seen in the developing world. It is a matter of special concern to us as approximately 20-30% of stroke occur in people younger than 45 years in India. Indians are prone to higher stroke risk because of urbanization, diabetes, cigarette smoking and high incidence of hypertension. Unfortunately, there is an inadequate awareness about the risk of stroke with hypertension among general public. Hypertension is considered to be the most important risk factor for stroke, and all forms of hypertension are associated with an increased risk of both ischemic and haemorrhagic stroke...
September 2016: Journal of the Association of Physicians of India
D Stott, M Bolten, D Paraschiv, I Papastefanou, J B Chambers, N A Kametas
OBJECTIVE: Pregnant hypertensive women who do not respond to labetalol but need vasodilatory therapy for blood pressure (BP) control rapidly progress to severe disease, which may be delayed by early recognition and individualised BP treatment. In this study, we sought to create prediction models at presentation, at 1 and 24 hours after commencement of treatment to identify patients who will not show a sustained response to labetalol and therefore need vasodilatory therapy. METHODS: The study population comprised of 134 women presenting with hypertension at a UK hospital...
October 20, 2016: Ultrasound in Obstetrics & Gynecology
Andrew J Beamish, Torsten Olbers, Aaron S Kelly, Thomas H Inge
Obesity is a major global health problem, and its multisystem effects are inextricably linked with elevated cardiovascular risk and adverse outcomes. The cardiovascular benefits of reversing obesity in adults are well-established. Compared with other weight-loss strategies, programmes that incorporate bariatric surgery for weight loss are beneficial for sustained BMI reduction. A marked improvement in cardiovascular risk factors, including hypertension, dyslipidaemia, inflammation, and type 2 diabetes mellitus, has been observed after bariatric surgery...
October 20, 2016: Nature Reviews. Cardiology
Mariana Moreira Coutinho Arroja, Emma Reid, Christopher McCabe
The renin angiotensin system (RAS) consists of the systemic hormone system, critically involved in regulation and homeostasis of normal physiological functions [i.e. blood pressure (BP), blood volume regulation], and an independent brain RAS, which is involved in the regulation of many functions such as memory, central control of BP and metabolic functions. In general terms, the RAS consists of two opposing axes; the 'classical axis' mediated primarily by Angiotensin II (Ang II), and the 'alternative axis' mediated mainly by Angiotensin-(1-7) (Ang-(1-7))...
2016: Experimental & Translational Stroke Medicine
Andrea Gruneir, Lauren E Griffith, Kathryn Fisher, Dilzayn Panjwani, Sima Gandhi, Li Sheng, Chris Patterson, Amiram Gafni, Jenny Ploeg, Maureen Markle-Reid
OBJECTIVE: To characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke. METHODS: This is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged 66 and over on April 1, 2008 (baseline), who had experienced a stroke at least 6 months prior. We estimated the prevalence of 14 comorbid conditions at baseline; we captured all physician visits, emergency department visits, hospital admissions, home care contacts, and associated costs over 5 years stratifying by number of comorbid conditions...
October 19, 2016: Neurology
Anne van der Vorst, G A Rixt Zijlstra, Nico De Witte, Daan Duppen, Andreas E Stuck, Gertrudis I J M Kempen, Jos M G A Schols
BACKGROUND: Most older people wish to age in place, for which functional status or being able to perform activities of daily living (ADLs) is an important precondition. However, along with the substantial growth of the (oldest) old, the number of people who develop limitations in ADLs or have functional decline dramatically increases in this part of the population. Therefore, it is important to gain insight into factors that can contribute to developing intervention strategies at older ages...
2016: PloS One
Sherry M Bumpus, Christa Kuck, Steven T Heidt, Minnie Bluhm
Fibromuscular dysplasia (FMD) is a vascular disorder about which little has been known until recently. Patients with FMD may suffer from hypertension, aneurysms, or strokes, as well as symptoms associated with local artery damage. As a result of advances in vascular medicine and growing outcomes registries, we now have a better understanding of the FMD disease process and epidemiology. Nevertheless, the consequences of FMD on patients' day-to-day experiences and mental health status are not well understood...
October 6, 2016: Vascular Medicine
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