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Coagulation Factor XIII Val34Leu Polymorphism in the Prediction of Premature Cardiovascular Events-The Results of Two Meta-Analyses. J Clin Med 2022; 11:jcm11123454. [PMID: 35743524 PMCID: PMC9225267 DOI: 10.3390/jcm11123454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/31/2022] [Accepted: 06/13/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Polymorphisms within the gene that encodes for coagulation factor XIII (FXIII) have been suggested to be involved in the pathogeneses of ischemic stroke (IS) and myocardial infarction (MI). The Val34Leu polymorphism is one of the most commonly analysed FXIII polymorphisms. However, studies on the role of the Val34Leu polymorphism in the aetiology of vascular diseases often show contradictory results. In the present meta-analysis, we aimed to pool data from available articles to assess the relationship between the FXIII Val34Leu polymorphism and the susceptibilities to IS of undetermined source and premature MI in patients aged below 55 years. Methods: We searched databases (PubMed, Embase, Google Scholar, SciELO, and Medline) using specific keywords (the last search was in January 2022). Eventually, 18 studies (627 cases and 1639 controls for IS; 2595 cases and 4255 controls for MI) met the inclusion criteria. Data were analysed using RevMan 5.4 and StatsDirect 3 link software. The relation between Val34Leu polymorphism and disease was analysed in five genetic models, i.e., dominant, recessive, additive, heterozygous, and allelic. Results: No relation between Val34Leu polymorphism and IS in young adults was observed in all analysed genetic models. For premature MI, significant pooled OR was found between the carrier state of the Leu allele (Val/Leu + Leu/Leu vs. Val/Val) and a lack of MI, suggesting its protective role (OR = 0.80 95%CI 0.64–0.99, p = 0.04). A similar finding was observed for the heterozygous model in MI (Val/Leu vs. Val/Val) (OR = 0.77 95%CI 0.61–0.98, p = 0.03). No relation was found for the recessive, additive, and allelic models in MI. Conclusions: In the population of young adults, no positive correlation was found between the FXIII Val34Leu polymorphism and IS of undetermined source in any of the analysed genetic models. In turn, the carrier state of the 34Leu allele as well as FXIII heterozygotes themselves were found to play a protective role in relation to premature MI.
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Ferreira J, Cunha P, Carneiro A, Vila I, Cunha C, Silva C, Longatto-Filho A, Mesquita A, Cotter J, Correia-Neves M, Mansilha A. Is Obesity a Risk Factor for Carotid Atherosclerotic Disease?—Opportunistic Review. J Cardiovasc Dev Dis 2022; 9:jcdd9050162. [PMID: 35621873 PMCID: PMC9144226 DOI: 10.3390/jcdd9050162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/02/2022] [Accepted: 05/08/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity is a risk factor for coronary atherosclerosis. However, the influence of adipose tissue in carotid atherosclerosis is not completely understood. No systematic review/meta-analysis was previously performed to understand if obesity is a risk factor for carotid atherosclerosis. This paper aims to provide an opportunistic review of the association between obesity and carotid atherosclerosis and define the role of the different adipose tissue depots in the characteristics of carotid stenosis. The databases PubMed and Cochrane Library were searched on 15–27 April and 19 May 2021. A total of 1750 articles published between 1985 and 2019 were identified, 64 were preselected, and 38 papers (35,339 subjects) were included in the final review. The most frequent methods used to determine obesity were anthropometric measures. Carotid plaque was mostly characterized by ultrasound. Overall obesity and visceral fat were not associated with the presence of carotid plaque when evaluated separately. Waist-hip ratio, however, was a significant anthropometric measure associated with the prevalence of carotid plaques. As it reflected the ratio of visceral and subcutaneous adipose tissue, the balance between these depots could impact the prevalence of carotid plaques.
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Affiliation(s)
- Joana Ferreira
- Vascular Surgery Department, Hospital de Trás-os-Montes, 5000-508 Vila Real, Portugal
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (P.C.); (I.V.); (C.C.); (C.S.); (A.L.-F.); (J.C.); (M.C.-N.)
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
- Correspondence: ; Tel.: +351-962-958-421
| | - Pedro Cunha
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (P.C.); (I.V.); (C.C.); (C.S.); (A.L.-F.); (J.C.); (M.C.-N.)
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
- Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
| | - Alexandre Carneiro
- Radiology Department, Unidade Local de Saúde Alto Minho, 4904-858 Viana do Castelo, Portugal;
| | - Isabel Vila
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (P.C.); (I.V.); (C.C.); (C.S.); (A.L.-F.); (J.C.); (M.C.-N.)
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
- Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
| | - Cristina Cunha
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (P.C.); (I.V.); (C.C.); (C.S.); (A.L.-F.); (J.C.); (M.C.-N.)
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
- Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
| | - Cristina Silva
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (P.C.); (I.V.); (C.C.); (C.S.); (A.L.-F.); (J.C.); (M.C.-N.)
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
- Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
| | - Adhemar Longatto-Filho
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (P.C.); (I.V.); (C.C.); (C.S.); (A.L.-F.); (J.C.); (M.C.-N.)
- Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
- Department of Pathology (LIM-14), University of São Paulo School of Medicine, São Paulo 01246-903, Brazil
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
| | - Amílcar Mesquita
- Vascular Surgery Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal;
| | - Jorge Cotter
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (P.C.); (I.V.); (C.C.); (C.S.); (A.L.-F.); (J.C.); (M.C.-N.)
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
- Medicine Department, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal
| | - Margarida Correia-Neves
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; (P.C.); (I.V.); (C.C.); (C.S.); (A.L.-F.); (J.C.); (M.C.-N.)
| | - Armando Mansilha
- Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal;
- Vascular Surgery Department, Hospital de São João, 4200-319 Porto, Portugal
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Mohammedin AS, Horaib WS, Alshamsi RA, Alrashdi SO, Aleidi DA, Al Subaie MS, Jatoi NA. Assessment of Cerebrovascular Accident and Transient Ischemic Attack Risk Factors in Elderly vs. Non-Elderly Patients at a Tertiary Care Hospital in Eastern Province, Saudi Arabia. Cureus 2021; 13:e18391. [PMID: 34729271 PMCID: PMC8556616 DOI: 10.7759/cureus.18391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background The survivors of cerebrovascular accidents (CVA) or stroke are often left with several mental and physical disabilities which create a major social and economic burden. However, research addressing the risk factors of CVA and transient ischemic attacks (TIA), and their complications are insufficient. Aim of the study To assess the CVA and TIA risk factors (hypertension, diabetes mellitus type 2, dyslipidemia, coronary artery disease, atrial fibrillation, obesity, hypercoagulopathy, anti-platelet and anticoagulant use, carotid artery stenosis, and hypothyroidism) and complications (pneumonia, urinary tract infection and deep venous thrombosis) among a sample of elderly patients compared to non-elderly adult patients receiving care at King Fahd Hospital of the University in Al-Khobar, Saudi Arabia. Methods A retrospective observational study was conducted at King Fahd Hospital of the University in Al-Khobar, Saudi Arabia. Multiple risk factors and complications of CVA and TIA were retrieved from the medical records of the studied patients that fulfilled the inclusion criteria of patients diagnosed with CVA and TIA aged ≥ 60 years (elderly sample) and 18-59 years old (comparison non-elderly sample), who were followed up by internal medicine, neurology, and geriatric medicine departments. The total participant size was 259 patients, of which 149 were elderly. Results The occurrence of risk factors was more common in the senior age group. Hypertension was the most frequent risk factor in both age groups, while dyslipidemia, atrial fibrillation, and obesity were significantly associated with the development of CVA and TIA in the elderly. Moreover, post-CVA and TIA complications were more frequent in the group with elderly patients, with urinary tract infections being the most reported complication. Conclusion This study concluded that the most frequent risk factors were hypertension and type 2 diabetes mellitus. The findings of this study call for providing extra preventive care for elderly patients with dyslipidemia, atrial fibrillation, and obesity, and for more aggressive prevention of post-CVA and TIA complications in older age groups.
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Affiliation(s)
- Ahmed S Mohammedin
- Geriatric Medicine, Ain Shams University Hospital, Cairo, EGY.,Geriatric Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU
| | - Wesal S Horaib
- Internal Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU
| | - Razan A Alshamsi
- Internal Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU
| | - Sallumah O Alrashdi
- Internal Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU
| | - Dalal A Aleidi
- Internal Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU
| | - Mudhawi S Al Subaie
- Internal Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU
| | - Noor-Ahmed Jatoi
- Vascular Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU
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Abstract
Insulin resistance often refers to a pathological condition in which cells fail to respond to the normal actions of insulin. Increasing literature has noted a critical role of insulin resistance in the pathogenesis of ischemic stroke. Insulin resistance plays an important role in the pathogenesis of ischemic stroke via enhancing advanced changes of atherosclerosis. A variety of literature indicates that insulin resistance enhances platelet adhesion, activation and aggregation which are conducive to the occurrence of ischemic stroke. Insulin resistance also induces hemodynamic disturbances and contributes to the onset of ischemic stroke. In addition, insulin resistance may augment the role of the modifiable risk factors in ischemic stroke and induce the occurrence of ischemic stroke. Preclinical and clinical studies have supported that improving insulin resistance may be an effective measure to prevent or delay ischemic stroke.
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Affiliation(s)
- Xiao-Ling Deng
- Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, 442000, Hubei Province, People's Republic of China
| | - Zhou Liu
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, and Institute of Neurology, Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China
| | - Chuanling Wang
- Department of Pathology, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Yanfeng Li
- Department of Neurology, Peking Union Medical College Hospital, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Zhiyou Cai
- Department of Neurology, Chongqing General Hospital, No. 312 Zhongshan First Road, Yuzhong District, Chongqing, 400013, People's Republic of China.
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Kamberi B, Kamberi F, Spiroski M. Vascular Genetic Variants and Ischemic Stroke Susceptibility in Albanians from the Republic of Macedonia. Open Access Maced J Med Sci 2016; 4:556-564. [PMID: 28028391 PMCID: PMC5175499 DOI: 10.3889/oamjms.2016.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Acute first-ever ischemic stroke (FIS) is a heterogeneous, polygenic disorder. The contribution of vascular genetic variants as inherited causes of ischemic stroke has remained controversial. AIM To examine the association of genetic variants in vascular factors with the occurrence of FIS. MATERIAL AND METHODS The current research was performed in a group of 39 patients with FIS (study group) and 102 healthy volunteers (control group). We analyzed the prevalence of vascular genetic variants in following genes: factor V, prothrombin, methylenetetrahydrofolate reductase (MTHFR), factor XIII, plasminogen activator 1, endothelial protein C receptor (EPCR), apolipoprotein B, apolipoprotein E, β-fibrinogen, human platelet antigen 1, angiotensin-converting enzyme (ACE), endothelial nitric oxide synthase (eNOS) and lymphotoxin alpha. RESULTS It was found that heterozygous LTA 804C>A and FXIII V34L Leu/Leu were significantly more frequent in patients with FIS than in control group (p = 0.036 and p = 0.017, respectively). The frequency of FXIII V34L Val/Val was significantly lower in patients with FIS than in control group (p = 0.020). Other frequencies of vascular gene variants in patients with FIS and in control group were not significantly different. CONCLUSIONS This is the first comprehensive study to present data indicating that polymorphism of vascular genes in the prevalence of acute FIS exists in the Albanian population from the Republic of Macedonia. Variations in these genes have been detected in patients with acute FIS, suggesting that their combination might act in a susceptible or protective manner in this Albanian population.
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Affiliation(s)
- Bajram Kamberi
- Neurological Department, Clinical Hospital, Tetovo, Republic of Macedonia
| | - Farije Kamberi
- School Medical Centre, “Nikolla Shtejn” Tetovo, Republic of Macedonia
| | - Mirko Spiroski
- Institute of Immunobiology and Human Genetics, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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Patgiri D, Pathak MS, Sharma P, Kutum T, Mattack N. Serum hsCRP: A Novel Marker for Prediction of Cerebrovascular Accidents (Stroke). J Clin Diagn Res 2014; 8:CC08-11. [PMID: 25653940 PMCID: PMC4316246 DOI: 10.7860/jcdr/2014/10386.5302] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 09/05/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES Strokes are caused by disruption of the blood supply to the brain. This may result from either blockage or rupture of a blood vessel. Yearly 15 million people worldwide suffer a stroke. India ranks second worldwide in terms of deaths from stroke. The incidence of stroke increases with age affecting the economically productive middle aged population. Hypertension and male sex are other risk factors for stroke. C-Reactive Protein (CRP) is an acute phase protein whose concentration rises in blood following inflammation. Formerly, assays for CRP detected its rise only after significant inflammation. However, recently developed high sensitivity assays (hsCRP) enable the measurement of CRP in individuals who are apparently healthy. Several studies indicate that hsCRP is elevated in individuals who are at risk of developing Coronary Artery Disease or Cerebrovascular events, the elevation may be found years before the first detection of vascular problems. In the absence of other biochemical markers, the present study aimed to evaluate the predictive and diagnostic role of hsCRP in stroke. MATERIALS AND METHODS The study consisted of 50 patients of acute stroke admitted in Gauhati Medical College and Hospital. The control population consisted of two groups - 50 age and sex matched controls with hypertension (Hypertensive control group) and 50 age and sex matched controls with no obvious disease constituted the Normal control group. hsCRP levels were measured in all the groups and compared statistically. CONCLUSION hsCRP is an acute phase reactant whose concentration rises in stroke as well as in those at risk. The rise may be identified even before the appearance of risk factors. Hence, hsCRP may be useful as a predictive and diagnostic marker in stroke.
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Affiliation(s)
- Dibyaratna Patgiri
- Demonstrator, Department of Biochemistry, Gauhati Medical College & Hospital, Guwahati, Assam, India
| | - Mauchumi Saikia Pathak
- Professor, Department of Biochemistry, Gauhati Medical College & Hospital, Guwahati, Assam, India
| | - Pradeep Sharma
- Assistant Professor, Department of Biochemistry, Mayo Institute of Medical Sciences, U.P, India
| | - Tridip Kutum
- Post-Graduate Trainee, Department of Biochemistry, Gauhati Medical College & Hospital, Guwahati, Assam, India
| | - Nirmali Mattack
- Post-Graduate Trainee, Department of Biochemistry, Gauhati Medical College & Hospital, Guwahati, Assam, India
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Tsupykov O, Kyryk V, Smozhanik E, Rybachuk O, Butenko G, Pivneva T, Skibo G. Long-term fate of grafted hippocampal neural progenitor cells following ischemic injury. J Neurosci Res 2014; 92:964-74. [DOI: 10.1002/jnr.23386] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 01/30/2014] [Accepted: 02/24/2014] [Indexed: 01/19/2023]
Affiliation(s)
- Oleg Tsupykov
- Bogomoletz Institute of Physiology; Kyiv Ukraine
- State Key Laboratory of Molecular and Cellular Biology; Kyiv Ukraine
- State Institute of Genetic and Regenerative Medicine; Kyiv Ukraine
| | - Vitaliy Kyryk
- State Institute of Genetic and Regenerative Medicine; Kyiv Ukraine
| | - Ekaterina Smozhanik
- Bogomoletz Institute of Physiology; Kyiv Ukraine
- State Key Laboratory of Molecular and Cellular Biology; Kyiv Ukraine
| | - Oksana Rybachuk
- Bogomoletz Institute of Physiology; Kyiv Ukraine
- State Key Laboratory of Molecular and Cellular Biology; Kyiv Ukraine
- State Institute of Genetic and Regenerative Medicine; Kyiv Ukraine
| | - Gennadii Butenko
- State Institute of Genetic and Regenerative Medicine; Kyiv Ukraine
| | - Tatyana Pivneva
- Bogomoletz Institute of Physiology; Kyiv Ukraine
- State Key Laboratory of Molecular and Cellular Biology; Kyiv Ukraine
- State Institute of Genetic and Regenerative Medicine; Kyiv Ukraine
| | - Galina Skibo
- Bogomoletz Institute of Physiology; Kyiv Ukraine
- State Key Laboratory of Molecular and Cellular Biology; Kyiv Ukraine
- State Institute of Genetic and Regenerative Medicine; Kyiv Ukraine
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Tsupykov O, Kyryk V, Rybachuk O, Poberezhnyi P, Mamchur A, Butenko G, Pivneva T, Skibo G. Effect of neural stem cell transplantation on cognitive functions of mice after cerebral ischemia-reperfusion. ACTA ACUST UNITED AC 2013. [DOI: 10.22494/cot.v1i1.51] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study is aimed to determine the effect of transplantation of neural progenitor cells (NPCs) isolated from fetal hippocampus on cognitive functions of experimental animals after short-term global cerebral ischemia. NPCs were isolated from hippocampus of FVB-Cg-Tg(GFPU)5Nagy/J mice, transgenic by the GFP. Ischemic brain injury in FVB “wild” type mice was modeled by bilateral occlusion of the common carotid arteries for 20 min. GFP-positive NPCs were stereotaxically transplanted into the hippocampus of experimental animals in 24 hours after ischemia-reperfusion. Cognitive functions were evaluated using Morris water maze. Results of this study showed that global short-term cerebral ischemia resulted into cognitive impairments in mice. Stereotaxic transplantation of NPCs promoted the cognitive function recovery in experimental animals after ischemic brain injury. Thus, the data indicates that transplantation of NPCs may have a therapeutic effect in treating of ischemic stroke.
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Gurr B, Ibbitson J. How does cognitive ability affect stroke rehabilitation outcomes? INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2012. [DOI: 10.12968/ijtr.2012.19.8.458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Birgit Gurr
- Poole Stroke Unit, Dorset, UK and Honorary Lecturer at Bournemouth University, UK and Johann-Gutenberg University Mainz, Germany and
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Jia Z, Wu S, Zhou Y, Wang W, Liu X, Wang L, Wang Y, Wang Y, Liang W, Zhao X, Zhang Y. Metabolic syndrome and its components as predictors of stroke in middle-aged and elderly Chinese people. Neurol Res 2012; 33:453-9. [PMID: 21669112 DOI: 10.1179/016164111x13007856083882] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND PURPOSE Little information is available on the role of metabolic syndrome (MetS) to predict first-ever stroke in the Chinese mainland. In this study, we investigated whether the metabolic syndrome and its single components, defined by original National Cholesterol Education Program (NCEP), International Diabetes Federation (IDF) and updated NCEP, could predict stroke in the middle-aged and elderly (40-85 years) Chinese population. METHODS In this prospective study, three metabolic syndrome definitions were applied to 19,369 subjects aged 40-85 years who were free of stroke and/or myocardial infarction at baseline and were followed up to 3 years. Multivariable Cox regression analysis was used to calculate the adjusted hazard ratios (HRs) and 95% confidence interval of metabolic syndrome and its single components with the first-ever stroke. RESULTS The metabolic syndrome defined by the original NCEP, IDF and updated NCEP were all significantly associated with stroke even after adjustment for confounding variables (HRs: 1.51 to 2.14). For the single components of metabolic syndrome, the following components predicted stroke incidence in both genders: insulin resistance or previous diagnosis with diabetes (HRs: 1.48-1.54 for men and 1.66-1.92 for women); blood pressure ≥ 130/85 mmHg or using medication (HRs: 2.54 for men and 2.31 for women). For men, central obesity defined by the IDF or updated NCEP criteria (waist circumference ≥ 90 cm) had association with stroke (HR: 1.47). However, none of criteria of central obesity was associated with stroke in female. CONCLUSIONS The metabolic syndrome is associated with first-ever stroke in this middle-aged and elderly Chinese population. Furthermore, blood pressure alone plays a more important role than metabolic syndrome in stroke risk in middle-aged and elderly Chinese population.
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Affiliation(s)
- Zhaoxia Jia
- Department of Epidemiology and Health Statistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China
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Hadjiev DI, Mineva PP. Antihypertensive treatment with cerebral hemodynamics monitoring by ultrasonography in elderly hypertensives without a history of stroke may prevent or slow down cognitive decline. A pending issue. Med Hypotheses 2010; 76:434-7. [PMID: 21134723 DOI: 10.1016/j.mehy.2010.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 11/13/2010] [Indexed: 11/28/2022]
Abstract
The role of the antihypertensive therapy in preventing cognitive disorders in elderly persons without a history of stroke is still a matter of debate. This article focuses on the pathogenesis of vascular cognitive disorders in hypertension and on the impact of antihypertensive treatment in their prevention. Cerebral white matter lesions, caused by small vessel disease and cerebral hypoperfusion, have been found in the majority of elderly hypertensives. They correlate with cognitive disorders, particularly impairments of attention and executive functions. Excessive blood pressure lowering in elderly patients with long-standing hypertension below a certain critical level, may increase the risk of further cerebral hypoperfusion because of disrupted cerebral blood flow autoregulation. As a result, worsening of the cognitive functions could occur, especially in cases with additional vascular risk factors. Five randomized, placebo-controlled trials have focused on the efficacy of antihypertensive treatments in preventing cognitive impairments in elderly patients without a prior cerebrovascular disease. Four of them have not found positive effects. We suggest that repeated neuropsychological assessments and ultrasonography for evaluation of carotid atherosclerosis, as well as cerebral hemodynamics monitoring could adjust the antihypertensive therapy with the aim to decrease the risk of cerebral hypoperfusion and prevent or slow down cognitive decline in elderly hypertensives. Prospective studies are needed to confirm such a treatment strategy.
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Hadjiev DI, Mineva PP. Which Patients Having Asymptomatic Carotid Artery Stenosis Might Benefit From Screening? Stroke 2010; 41:e587; author reply 588. [DOI: 10.1161/strokeaha.110.594184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hadjiev DI, Mineva PP. Antihypertensive treatment in elderly hypertensives without a history of stroke and the risk of cognitive disorders. Acta Neurol Scand 2008; 118:139-45. [PMID: 18336621 DOI: 10.1111/j.1600-0404.2008.01001.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The role of the antihypertensive therapy in preventing cognitive disorders in elderly persons without a history of stroke is a matter of debate. This review focuses on the pathogenesis of the cognitive disorders in elderly hypertensives and on the risk factors of their occurrence. METHODS Relevant papers were identified by searches in PubMed from 1946 until October 2007, using the key words 'vascular risk factors', 'vascular cognitive impairment', 'vascular dementia', 'neuroimaging in hypertension' and 'antihypertensive treatment'. RESULTS Blood pressure lowering in elderly patients with long-standing hypertension below a certain critical level may increase the risk of cerebral hypoperfusion and cognitive decline, particularly in cases with additional vascular risk factors. Cerebral white matter lesions have been found in the majority of elderly hypertensives. They have been shown to correlate with cognitive disorders. CONCLUSIONS Appropriate neuropsychological assessment and follow-up of the cognitive functions could be considered with the aim to individualize the antihypertensive therapy and slow down cognitive decline. Prospective studies are needed to confirm such a treatment strategy.
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Affiliation(s)
- D I Hadjiev
- University Hospital of Neurology and Psychiatry St. Naum, Medical University, Sofia, Bulgaria.
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Abstract
OBJECTIVE The role of the antihypertensive therapy in preventing vascular cognitive disorders in elderly persons without a history of stroke is a matter of debate. This review focuses on cognitive disorders in elderly hypertensive patients. METHODS Relevant papers were identified by searches in PubMed from 1946 until February 2007 using the keywords 'cerebral blood flow autoregulation', 'vascular cognitive disorders', 'neuroimaging in hypertension', 'antihypertensive treatment' and 'neuroprotection in cerebral ischemia'. RESULTS Excessive blood pressure lowering in patients with long-standing hypertension may increase the risk of cerebral hypoperfusion, white matter lesions and consequent cognitive decline. White matter lesions have been found in the majority of patients with long-standing hypertension. They correlate with vascular cognitive disorders, particularly impairments of attention and executive function, while memory is relatively preserved. Cerebral small vessel disease in elderly patients should be taken into account when antihypertensive treatment is considered. Renin-angiotensin blockade, some calcium channel blockers and statins are thought to possess neuroprotective action. CONCLUSION For prevention of cerebral hypoperfusion in elderly hypertensives blood pressure lowering should be cautiously controlled. The increased risk of white matter lesions is an indication for early neuroprotection. The combination of renin-angiotensin blockade or calcium channel blockers with statins may become a promising preventive strategy against cognitive decline in elderly hypertensives. Cerebral white matter protection is a future challenge.
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Affiliation(s)
- Dimiter Hadjiev
- 1University Hospital of Neurology and Psychiatry 'St Naum', Medical University, Sofia, Bulgaria
| | - Petya Mineva
- 2Medical Faculty, Department of Neurology and Psychiatry, Thracian University, Stara Zagora, Bulgaria
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15
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Jago R, Nicklas T, Yang SJ, Baranowski T, Zakeri I, Berenson GS. Physical activity and health enhancing dietary behaviors in young adults: Bogalusa Heart Study. Prev Med 2005; 41:194-202. [PMID: 15917011 DOI: 10.1016/j.ypmed.2004.09.045] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2004] [Revised: 05/19/2004] [Accepted: 09/07/2004] [Indexed: 11/15/2022]
Abstract
BACKGROUND Obesity results from energy imbalance. This study used data from the Bogalusa Heart Study to examine relationships between the dietary and physical activity behaviors of young adults. METHODS One thousand one hundred ninety-one young adults (76% Euro-American, 24% African-American, 61% female) completed a food frequency questionnaire and reported the location of meals consumed. Physical activity outside of work was assessed using a 5-item Likert scale. Analyses of covariance were used to determine if dietary consumption differed by physical activity level after controlling for ethnicity, BMI, age, and gender. Regression models were used to explore two- and three-way diet, gender, and ethnicity interactions. RESULTS Consumption of fruit and dairy foods significantly differed (P < 0.05) by activity level with the most active group consuming 0.4 more servings per day for both fruit/fruit juices and dairy. Increased physical activity was significantly associated (P < 0.05) with decreased dietary fat. Increased physical activity was associated with increased consumption of fat among African-American males and decreased consumption of fat among Euro-American males. Euro-American females consumed less energy than the three other ethnic/gender groups. CONCLUSIONS Increased consumption of fruit, dairy foods, and reduced energy from fat were related with increased physical activity with this relationship differing by gender and ethnicity.
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Affiliation(s)
- Russell Jago
- Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA.
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16
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Nazir FS, Lees KR, Bone I. Clinical features associated with medically unexplained stroke-like symptoms presenting to an acute stroke unit. Eur J Neurol 2005; 12:81-5. [PMID: 15679694 DOI: 10.1111/j.1468-1331.2004.01010.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In many areas of secondary care, symptoms unexplained by disease account for around one-third of all patients seen. We sought to investigate patients presenting with medically unexplained stroke-like symptoms to identify distinguishing features which may help to identify a non-organic aetiology. Patients given a discharge diagnosis of medically unexplained stroke-like symptoms over the preceding 11 years were identified retrospectively from a prospectively completed stroke unit database. Age- and sex-matched controls with ischaemic or haemorrhagic stroke or transient ischaemic attack were also identified. Clinical features on presentation, ischaemic risk factors, alcohol history, marital status and history of depression or anxiety were examined. Previous or subsequent admissions with medically unexplained syndromes were also examined via record linkage with hospital discharge records. A medically unexplained syndrome was assumed to be present if an International Classification of Diseases 9 discharge code for one or more of the thirteen conditions forming recognized functional syndromes was given. Logistic regression was applied to determine predictors of non-organicity. One hundred and five patients and controls, 1.6% of all stroke unit admissions were identified, 62% (65 patients) were females. Mean age was 50.3 +/- 14.9. Compared with age- and sex-matched controls patients with medically unexplained stroke-like symptoms were significantly more probable to have a headache at presentation (47% vs. 26%, P = 0.0004), have a diagnosis of one or more additional medically unexplained syndromes (24% vs. 11%, P = 0.007) but significantly less probable to present with symptoms of vertebrobasilar dysfunction (32% vs. 61%, P < 0.0001). A history of anxiety or depression, as recorded in the notes, was not found to be associated with a medically unexplained presentation. Medically unexplained stroke-like presentations are common (1.6% of all stroke presentations), they are most strongly predicted by the presence of other functional somatic syndromes, headache and the absence of symptoms of vertebrobasilar dysfunction.
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Affiliation(s)
- F S Nazir
- Division of Cardiovascular and Medical Sciences, University of Glasgow, Southern General Hospital, 1345 Govan Road, Glasgow, Scotland, UK.
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17
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Baños JH, Elliott TR, Schmitt M. Factor Structure of the Rey Auditory Verbal Learning Test in Adults With Spinal Cord Injury. Rehabil Psychol 2005. [DOI: 10.1037/0090-5550.50.4.375] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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18
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Iglseder B, Moroder T, Staffen W, Ladurner G. Inadequate management of cerebrovascular risk factors in participants of a public stroke prevention program in Austria. Eur J Neurol 2004; 11:679-85. [PMID: 15469452 DOI: 10.1111/j.1468-1331.2004.00912.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of our investigation was to identify frequencies and treatment quality of stroke risk factors in participants of a stroke prevention program in the province of Salzburg (Austria). A total of 9356 participants free of previous stroke were classified in three risk categories for suffering from ischemic stroke within the next 10 years and analyzed referring to history, therapy, and treatment quality of cerebrovascular risk factors. A total of 6519 (69.7%) participants were classified to be at low (<10%), 2232 (23.9%) at intermediate (10-20%) and 605 (6.5%) at high risk (>20%). Elevated blood pressure with the need for follow-up investigations was found in 5193 persons (55.5%); of 3713 (39.7%) persons with a history of hypertension, 3204 (86.3%) are under medical treatment, which is sufficient only in 765 patients (23.9%). Similar results were present for other well documented modifiable risk factors. In the investigated population there is high presence of stroke risk factors with inadequate treatment in most cases.
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Affiliation(s)
- B Iglseder
- Department of Neurology, Christian Doppler Clinic, Paracelsus Private Medical School, Salzburg, Ignaz-Harrer-Strasse, Salzburg, Austria.
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