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New ACC/AHA guidance for preventing heart disease, stroke released

New ACC/AHA guidance for preventing heart disease, stroke released

First published on ScienceDaily.com

The choices we make every day can have a lasting effect on our heart and vascular health. Adopting a heart healthy eating plan, getting more exercise, avoiding tobacco and managing known risk factors are among the key recommendations in the 2019 Primary Prevention of Cardiovascular Disease guideline from the American College of Cardiology (ACC) and the American Heart Association (AHA). Also, it is recommended that aspirin should only rarely be used to help prevent heart attacks and stroke in people without known cardiovascular disease.

The guideline, presented today at ACC’s 68th Annual Scientific Session, offers comprehensive but practical recommendations for preventing cardiovascular disease, which remains the leading cause of death for both men and women in the United States. Nearly 1 out of 3 deaths in the U.S. is due to cardiovascular disease.

“The most important way to prevent cardiovascular disease, whether it’s a build-up of plaque in the arteries, heart attack, stroke, heart failure or issues with how the heart contracts and pumps blood to the rest of the body, is by adopting heart healthy habits and to do so over one’s lifetime,” said Roger S. Blumenthal, MD, co-chair of the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease and the Kenneth Jay Pollin Professor of Cardiology at Johns Hopkins Medicine. “More than 80 percent of all cardiovascular events are preventable through lifestyle changes, yet we often fall short in terms of implementing these strategies and controlling other risk factors.”

Read the full article here.

Researchers explore stroke’s effects on microbiome

Researchers explore stroke’s effects on microbiome

First published on ScienceDaily.com

Tumult in the bacterial community that occupies your gut — known as your microbiome — doesn’t just cause indigestion. For people recovering from a stroke, it may influence how they get better.

A recent study by Allison Brichacek and Candice Brown, researchers in the West Virginia University School of Medicine, suggests that stroke patients’ microbiomes — and even the structure of their guts — may still be out of kilter a month after the stroke has passed.

“We’re interested in the gut-brain axis — how the gut influences the brain and vice versa,” said Brichacek, a doctoral student in the immunology and microbial pathogenesis graduate program. She presented her findings at the International Stroke Conference in February.

Previous studies indicated the immediate effects a stroke can have on someone’s microbiome, but they didn’t explore whether these effects lingered. To find out, Brichacek, Brown and their colleagues — including Sophia Kenney, an undergraduate majoring in immunology and medical microbiology, and Stan Benkovic, a researcher in Brown’s lab — induced a stroke in animal models. Other models — the control group — didn’t have a stroke. The researchers compared the two groups’ microbiomes three days, 14 days and 28 days post-stroke. They also scrutinized their intestines for microscopic disparities.

Bacterial friend or foe?

One of the researchers’ discoveries was that a certain family of bacteria — Bifidobacteriaceae — was less prominent in post-stroke models than in healthy ones both 14 and 28 days out. If the name of the family sounds familiar, that’s probably because Bifidobacterium — a genus within the Bifidobacteriaceae family — is a common ingredient in yogurt and probiotics. These bacteria are known for supporting digestive health and may be associated with better outcomes in stroke patients.

Read the full article here.

#BrainLifeGoals: Brain Awareness Week 2019 starts now

#BrainLifeGoals: Brain Awareness Week 2019 starts now

Sharing #LifeGoals has become a popular trend on social media. A campaign from the European Federation of Neurological Associations [EFNA] and supported by many organisations across Europe will put a new spin on the trend by instead seeing patient advocates and supporters share their #BrainLifeGoals.
The #BrainLifeGoals campaign will raise awareness of the impact of neurological diseases by exploring the dreams and aspirations of those living with a brain disorder.

You can find out more about the campaign at www.efna.net/brainlifegoals and by following the #BrainLifeGoals hashtag on social media.

Sleep after stroke: How does it affect recovery?

Sleep after stroke: How does it affect recovery?

This article first appeared on ARNI Stroke Charity (UK) website | Author: Tom Balchin

Are you interested in learning about your sleep after stroke?

Researchers at the University of Oxford are currently investigating how sleep is affected by stroke.

Heidi Johansen-Berg is Professor of Cognitive Neuroscience and Director of The Wellcome Centre for Integrative Neuroimaging at the University of Oxford. There, she leads the Plasticity Group whose research focuses on how the brain changes with learning, experience, and damage.

As well as shedding light on how the healthy brain responds to change, The Plasticity Group’s work also has implications for understanding and treating disease. For example, they are currently studying how sleep can affect recovery after stroke.

Would you be interested in learning more about your sleep following stroke?

If so, The Plasticity Group are currently running a study in which you might be interested in participating – or you may know someone who is.

The aim for this study is to investigate how sleep is affected by stroke which could help to develop better sleep improvement programmes specifically for individuals after stroke.

We know that sleep plays an important role in learning. Studies have shown that if you take two groups of people and teach them the same skill, such as juggling, then allow one group to sleep for a few hours and keep the other group awake, the sleep group will perform significantly better when retested as they have been able to consolidate the memories of learning the skill through sleep.

Learning, or re-learning, of motor skills is a key component of motor rehabilitation after stroke. If sleep is impaired following stroke then consolidation of motor skills gained through physical rehabilitation may be diminished. Therefore, finding out about how sleep is affected by stroke could help us to develop better rehab outcomes following stroke.

The current study involves coming to a research centre in Oxford for one session to complete a couple of motor assessments with the upper limbs and to answer a couple of questionnaires about your sleep and mood. Then researchers will set you up with a pair of sleep monitoring wrist watches for you to wear for a week with a simple sleep diary asking what times you go to bed and get up each day.

Read the full article here.

 

Understanding how to beat fatigue after stroke

Understanding how to beat fatigue after stroke

This article first appeared on ARNI Stroke Charity (UK) website | Author: Tom Balchin

Tiredness is something we all experience in our everyday lives. But fatigue is where we experience tiredness which is unrelated to physical or mental exertion, and is not alleviated by rest. Up to 70% of survivors experience fatigue, characterised by overwhelming physical and/or mental tiredness or exhaustion. For many the symptoms dissipate and lessen over time. Others continue to experience these symptoms at a high level many years after their stroke. This is called chronic fatigue.

It is a condition which can greatly impact upon the quality of an individual’s life, making everyday tasks feel overwhelming and unachievable, or just plain exhausting.

Previously, it was thought that patients who experience depression post-stroke were fatigued as a result of their mental health, whereas it is now highly possible that the inverse relationship may, in fact, be true. Fatigue may often be the cause, or a significant contributing factor, of depression.

There is currently no clinical method for diagnosing fatigue, and no treatment is available to alleviate the condition.

Research into fatigue is at its very early stages. Work to contribute towards a treatment has now been spearheaded by Dr Anna Kuppuswamy, the lead researcher on the project.

Her study aims to further general understanding of how fatigue works in the brain, and whether or not it can be alleviated. The goal for the future is to be able to diagnose and treat fatigue effectively, so that no-one need experience its debilitating effects.

So, how can you help?

STROKE SURVIVORS EXPERIENCING HIGH LEVELS OF FATIGUE –

Please come to help Dr Kuppuswamy’s Team test a new intervention for fatigue!

You can read the full article here.

For more information about the UK ARNI Institute please visit their website.

 

 

 

 

Your weight history may predict your heart failure risk

Your weight history may predict your heart failure risk

First published on ScienceDaily.com

In a medical records analysis of information gathered on more than 6,000 people, Johns Hopkins Medicine researchers conclude that simply asking older adult patients about their weight history at ages 20 and 40 could provide real value to clinicians in their efforts to predict patients’ future risk of heart failure, heart attacks or strokes.

In a report published Nov. 14 in the Journal of the American Heart Association, the investigators say the younger-weight question is potentially a cost-efficient, high-value “ask” likely to help physicians decide how to advise and treat their older patients, particularly now that many people change primary care physicians throughout their lives, and lifelong health records may not transfer. Asking this simple question about prior lifetime weights provided prognostic information about a person’s heart failure risk that was incremental to their measured weights at older ages and other measured traditional heart disease risk factors.

“We’ve known that the longer a person is obese, the more it becomes problematic by increasing their heart failure risk,” says Erin Michos, M.D., M.H.S., associate professor of medicine at the Johns Hopkins University School of Medicine. “That is why measuring a person’s weight at older ages may not tell the whole story about their risk. There’s now more evidence that newly obese people are in overall less danger. Our findings emphasize the importance of lifelong maintenance of a healthy weight, as greater cumulative weight from young adulthood is more risky to heart health.”

“We already routinely measure weights during a patient’s clinic visit to make health recommendations, but we think adding this low-tech question about their prior weight histories can further help direct clinical care,” she adds. “While we acknowledge that self-reported weight history is imperfect, at the very least, asking the question sparks patient reflection and self-motivation to get back to healthier weights from their younger ages.”

Heart attacks, strokes and other cardiovascular diseases remain the No. 1 killers of Americans. Heart failure, also known as congestive heart failure, is a condition marked by a gradual weakening and stiffening of the heart muscle, diminishing its ability to pump blood. Physicians routinely attempt to assess risks for heart disease and heart failure as patients age with measures of blood pressure, cholesterol, exercise levels, family history, diet and weight, Michos noted. Although a single weight measurement in an older adult is helpful, she says, weight history is even more informative, and the new study was in part designed to identify a practical way of getting it that would be considered informative enough to add to clinical care.

For the study, the researchers used data already gathered on 6,437 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) recruited between 2000 and 2002 who were age 45 to 84 at time of enrollment into the study. Participants were followed an average of 13 years, and lived in six U.S. communities: Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; New York City, New York; Los Angeles County, California; and St. Paul, Minnesota. On average, they were 62 years old at the study’s start. Almost 53 percent of the participants were women. About 39 percent of participants were white, more than 26 percent were African-American, 22 percent were Hispanic and a little more than 12 percent were Chinese-American.

Each participant filled out a survey that reported their weight history at age 20 and 40. Their weights were further tracked during the study period using measurements from a standardized scale over five different in-person visits. All weights were converted to body mass indexes (BMI) by dividing the weight by the square of height. A BMI less than 25 kilograms per meter squared was considered normal, while a BMI between 25 and 30 was considered overweight, and 30 and above was considered obese.

By the end of all participants’ last visit, 290 people had experienced heart failure, and 828 experienced cardiovascular disease events such as heart attacks, stroke and or death as determined by participant and family interviews and patient medical records.

As expected, Michos says, the standard measured weights taken at clinic visits during the 13-year study period were associated with later heart failure risk, with a 34 percent increased likelihood of heart failure for every 5 kilograms per meters squared increase in BMI, after accounting for other established heart disease risk factors such as age, smoking, physical activity, blood pressure and diabetes. But then her team found that even after taking into account these current measured weights at older ages, that having a self-reported history of obesity at age 20 (144 participants) was associated with a more than threefold risk of heart failure, and having a history of being obese at age 40 (716 participants) doubled the risk compared with people who had a BMI in the normal range at those ages.

“Our study confirms that maintaining a normal weight over the lifespan is the most ideal, and that when and for how long a person becomes obese are highly informative in assessing heart disease risk in older adults,” says Michos.

Michos cautioned that the new study was designed to look at associations between self-reported lifetime weights and heart disease risk over time, and not determine cause and effect or attempt to determine the accuracy of patients’ recall of their weight at young ages. Patient self-reporting can result in bias or imperfect memory, but the researchers believe most older adults have reasonably accurate recall of their younger adult weight. Their study findings suggest that even with these known limitations of weight recall, that simply asking about weight history was helpful in risk assessment. Right now, clinicians just don’t routinely ask about a person’s weights at key life points such as young- and mid-adulthood, Michos says, but it is so easy to do.

Michos says that we need to investigate how we can incorporate this ask (about lifetime weight recall) into electronic health records and into clinical practice.

About 1 in 3 deaths in the U.S. are due to heart disease, according to the American Heart Association. About 92 million American adults are living with some form of cardiovascular disease. About 5.7 million people in the U.S. live with heart failure, and more than half a million are diagnosed each year. More than half of people with heart failure will die within five years of diagnosis, according to the Centers for Disease Control and Prevention.

Story Source:
Johns Hopkins Medicine. “Your weight history may predict your heart failure risk: Low-tech reporting on earlier weights may guide clinical care.” ScienceDaily. ScienceDaily, 12 December 2018. <www.sciencedaily.com/releases/2018/12/181212093327.htm>.