Antithrombotic Drugs Play a Significant Role in Intracerebral Hemorrhage in the Elderly Patients

The Role of Aging in Intracerebral Hemorrhage

Intracerebral hemorrhage (ICH) is the cerebrovascular disease with the highest disability and mortality rates, causing severe damage to the health of patients and imposing a significant socioeconomic burden. Aging stands as a foremost risk factor for ICH, with a significant escalation in ICH incidence within the elderly demographic, highlighting a close association between ICH and aging. In recent years, with the acceleration of the "aging society" trend, exploring the intricate relationship between aging and ICH has become increasingly urgent and worthy of in-depth attention. We have summarized the characteristics of ICH in the elderly, reviewing how aging influences the onset and development of ICH by examining its etiology and the mechanisms of damage via ICH. Additionally, we explored the potential impacts of ICH on accelerated aging, including its effects on cognitive abilities, quality of life, and lifespan. This review aims to reveal the connection between aging and ICH, providing new ideas and insights for future ICH research.

Household dietary salt consumption and mortality from cardiovascular diseases: an ecological panel analysis in Japan

Background

Epidemiological evidence has shown that lower salt intake reduces hypertension-related disease mortality. Japan has experienced a drastic decrease in cardiovascular mortality, although this varies across regions. This regional variation does not necessarily match the local patterns of reported average salt intake. In this study, we examined population-level risk factors for hypertension-related disease mortality, focussing on the average household dietary consumption of salt intake sources.

Methods

We prepared an ecological panel dataset, with prefecture as the unit of analysis, by referring to public statistics and market research data from 2012 to 2015. We collected prefectural averages of household dietary consumption related to salt intake and other nutrients that may affect hypertension control. We used demographic characteristics, medical care availability and local economy indices as covariates. Panel data analysis with fixed-effects modelling was performed, regressing prefectural-level mortality from ischaemic heart diseases, subarachnoid and intracerebral haemorrhage and cerebral infarction on dietary consumption and the selected covariates.

Results

We confirmed the average household consumption of salt equivalents of discretional salt intake sources to be positively but only weakly associated with mortality from ischaemic heart diseases and cerebral infarction. Household expenditure on processed foods was positively associated with ischaemic heart disease mortality.

Conclusions

These findings may suggest that the reduction of salt in processed foods, in addition to individual behavioural change, could be useful for decreasing mortality from ischaemic heart diseases in the Japanese population. Ecological factors related to decreasing cerebrovascular disease mortality in the context of the ageing Japanese population require further investigation.

Impact of Antiplatelets and Anticoagulants on the Prognosis of Intracerebral Hemorrhage

BACKGROUND

Intracerebral hemorrhage (ICH) associated with antithrombotic therapy (AT) is becoming more common as the use of those medications increases in the aging population.

METHODS

This study included 490 consecutive patients hospitalized for nontraumatic ICH in a single center during an 8-year period, which was subdivided into former (2008-2011) and latter (2012-2015). Patients were classified into those with no antithrombotic drugs (NATs) and those with AT. The AT group was divided into 4 subgroups according to medications: antiplatelet (AP1), multiple antiplatelets (AP2), anticoagulant (AC), and antiplatelet and anticoagulant (APC). We evaluated the clinical characteristics and prognosis and compared the number of patients on AT between the former and latter groups.

RESULTS

There were 125 patients treated with AT (25.5%), including 50 (10.2%) on AP1, 14 (2.9%) on AP2, 32 (6.5%) on ACs, and 29 (5.9%) on APCs. Compared with the former group, the latter group had a higher number of patients on AT (19.3% versus 31.7%), AP1 (9.8% versus 10.6%), AP2 (1.6% versus 4.1%), ACs (4.9% versus 8.1%), and APCs (2.90% versus 8.9%). Compared with the NAT group, the patients in the AT group had a larger ICH volume, more frequent hematoma expansion, and higher rate of poor outcome, particularly for those on APCs.

CONCLUSION

The number of ICH patients on AT has increased; these patients were more likely to have a poor prognosis than those who were not on AT. Care should be taken when giving a combination of antiplatelets and anticoagulants in ICH.

Impact of pneumonia and lung cancer on mortality of women with hypertension

Essential hypertension is one of the most severe women's health problems. Modern life brings more chances of pulmonary diseases to human. The purpose of the study is to investigate weather pneumonia and lung cancer are associated with the mortality of women with hypertension in different age. A cross-sectional retrospective study was conducted in women with hypertension, who were admitted into our hospital in 2004-2013. 14219 women were enrolled and 68.8 ± 12.2 year old (y). Isolated hypertension was 14.7%. The age of death was 78.1 ± 9.8 y. The mortality was 4.4% for average and 0.2%, 1.1%, 2.4%, 4.8%, 10.4% and 15.8% in group age ≦49, 50-59, 60-69, 70-79, 80-89 and ≧90 y separately. This mortality increased with age was positively significantly correlated with the increased incidences of pneumonia (P < 0.05, r = 0.77). Pneumonia was a significant risk associated with the mortality in age 55-89 y (OR = 6.4-22.5; 95% CI = 3.06-51.12). While, lung cancer was the significant risk in 70-79 y. These observations indicate that pneumonia and lung cancer are significant risk factors associated with the mortality of certain age women with hypertension, and bring an alert that pneumonia and lung cancer should be prevented and treated intensively in modern life in order to reduce the mortality.