Nov 15, 2018
Published first on ScienceDaily.com
Exposure to environmental noise appears to increase the risk of heart attacks and strokes by fueling the activity of a brain region involved in stress response. This response in turn promotes blood vessel inflammation, according to preliminary research to be presented in Chicago at the American Heart Association’s Scientific Sessions 2018, a premier global exchange of the latest advances in cardiovascular science for researchers and clinicians.
The findings reveal that people with the highest levels of chronic noise exposure — such as highway and airport noise — had an increased risk of suffering cardiovascular events such as heart attacks and strokes, regardless of other risk factors known to increase cardiovascular risk.
The results of the study offer much-needed insight into the biological mechanisms of the well-known, but poorly understood, interplay between cardiovascular disease and chronic noise exposure, researchers said.
“A growing body of research reveals an association between ambient noise and cardiovascular disease, but the physiological mechanisms behind it have remained unclear,” said study author Azar Radfar, M.D., Ph.D., a research fellow at the Massachusetts General Hospital in Boston. “We believe our findings offer an important insight into the biology behind this phenomenon.”
Researchers analyzed the association between noise exposure and major cardiovascular events, such as heart attacks and strokes, among 499 people (average age 56 years), who had simultaneous PET and CT scan imaging of their brains and blood vessels. Diagnostic validation was done in a subset of 281 subjects.
All participants were free of cardiovascular illness and cancer at baseline. Using those images, the scientists assessed the activity of the amygdala — an area of the brain involved in stress regulation and emotional responses, among other functions. To capture cardiovascular risk, the researchers examined the participants’ medical records following the initial imaging studies. Of the 499 participants, 40 experienced a cardiovascular event (e.g., heart attack or stroke) in the five years following the initial testing.
To gauge noise exposure, the researchers used participants’ home addresses and derived noise level estimates from the Department of Transportation’s Aviation and Highway Noise Map.
People with the highest levels of noise exposure had higher levels of amygdalar activity and more inflammation in their arteries. Notably, these people also had a greater than three-fold risk of suffering a heart attack or a stroke and other major cardiovascular events, compared with people who had lower levels of noise exposure. That risk remained elevated even after the researchers accounted for other cardiovascular and environmental risk factors, including air pollution, high cholesterol, smoking and diabetes.
Additional analysis revealed that high levels of amygdalar activity appears to unleash a pathway that fuels cardiac risk by driving blood vessel inflammation, a well-known risk factor for cardiovascular disease.
The researchers caution that more research is needed to determine whether reduction in noise exposure could meaningfully lower cardiovascular risk and reduce the number of cardiovascular events on a population-wide scale.
In the meantime, however, the new study findings should propel clinicians to consider chronic exposure to high levels of ambient noise as an independent risk factor for cardiovascular disease.
“Patients and their physicians should consider chronic noise exposure when assessing cardiovascular risk and may wish to take steps to minimize or mitigate such chronic exposure,” Radfar said.
Story Source:American Heart Association. “Chronic exposure to excess noise may increase risk for heart disease, stroke.” ScienceDaily. ScienceDaily, 5 November 2018. <www.sciencedaily.com/releases/2018/11/181105081749.htm>.
Nov 14, 2018
For a substantial part of my professional career I have worked in the field of digital communication and services. I not only appreciate the value that digital tools can bring to the health care sector from a professional stand point but from a personal one too. Several years ago, my former wife suffered a serious stroke which resulted in her having a severe form of aphasia; her ability to both speak and understand language verbally or in writing was impaired. We found that an iPad could offer many digital solutions for her and she made intensive use of it to help communicate with us.
When I heard that SAFE was exploring a digital way to share knowledge in an innovative way, I was very pleased and naturally wanted to cooperate. Initially, I became involved with the SSOFT Champion Group which consisted of stroke survivors and other members of SSOs from across Europe. We looked at designs, listen to voiceover artists and fed back our input directly back to the design team. I decided then to also become part of the User Acceptance Testing Group, and I testing the first few modules very intensively due to my experience with digital applications. Thanks to testing work carried out by the various volunteers, the project team was able to make great strides forwards. Every subsequent module developed became better and better.
SSOFT is a fully-fledged eLearning tool that covers the many aspects that play a role in the support and advocacy of people with a stroke. The modules make optimal use of text, images and video to share more knowledge; making it very pleasant to use.
SSOFT has great potential to expand, I hope that the tool will never be truly “finished” but remain a live environment that always adapts to the latest developments and experiences. I would truly like to see it succeed and expand into a community platform where people can share experiences and knowledge across Europe. The first step has been taken with the current version of SSOFT and future developments will become clear through intensive use.
About the author
André is an active National Board member of Hersenletsel.nl, the largest association in the Netherlands that represents the interests of people with non-congenital brain injuries, including stroke. He is also an expert on digital communication and services who advises the government and healthcare sector in the Netherlands. André has been actively involved as a Champion in the initial stages of development of SSOFT as well as a User Acceptance Tester for many of the modules contained with SSOFT.
Nov 9, 2018
In the UK, health policy recommends that stroke survivors should be reviewed at six-weeks, six-months and at one year after their stroke1,2. However, reviews are carried out differently across the UK and the process has not been properly evaluated. This study explored the review process, focusing on the six-month review. Three sites were selected in England. We interviewed stroke survivors and their carers at six-weeks, six-months, and where possible one year after coming home from hospital. We also observed their reviews and interviewed clinicians, managers and commissioners. We interviewed 46 stroke survivors, 30 carers and 28 professionals.
We found that reviews carried out by stroke nurses were focused on medical issues whereas those completed by a Stroke Association co-ordinator were more focused on social issues. Professionals usually saw the review as an opportunity to follow-up on issues that needed to be dealt with and signpost to other services. However, stroke survivors’ experience of the review was influenced by their experiences in hospital, their understanding of rehabilitation and their relationships with clinicians. They identified different priorities to those of reviewers, particularly when they had other long-term conditions.
Overall, most people found the six-month review helpful but not the six-week or the yearly review. Rather than having the review at set intervals, it would be more helpful if it coincided with coming home from hospital and after community rehabilitation has finished. Reviews need to link with what has gone before, for example, information on preventing another stroke. It would also be helpful to review therapy goals and encourage stroke survivors to set their own new goals for the next stage of their recovery.
Further information: V.J.Abrahamson@kent.ac.uk or @vabrahamsonUoK
Full article: https://onlinelibrary.wiley.com/doi/full/10.1111/hsc.12677#.W9rVLwczfHY.twitter
References:
Department of Health (2007). National Stroke Strategy [Online]. Available from: http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Longtermconditions/Vascular/Stroke/DH_099065.
Royal College of Physicians (2016). National Clinical Guidelines for Stroke. Intercollegiate Stroke Working Party. Fifth Edition [Online]. Available from: https://www.rcplondon.ac.uk/guidelines-policy/stroke-guidelines.
Nov 6, 2018
Published first on ScienceDaily.com
One of Australia’s biggest health issues could be checked if more people took up yoga or tai chi and reduced their blood pressure, an Australian study has found.
Stroke costs the country $5 billion a year through treatment and loss of productivity, affecting 56,000 Australians in 2017, equivalent to one stroke every nine minutes.
A paper published in Future Neurology by researchers from Monash University, the University of South Australia (UniSA) and the University of Melbourne shows the impact that mindfulness-based interventions (MBIs) such as yoga and tai chi can have on reducing hypertension, fatty acids and blood sugar levels — all risk factors for stroke.
Researchers say both Eastern practices have the potential to mitigate stroke risk as well as help support stroke survivors.
UniSA Senior Lecturer in Human Movement, Dr Maarten Immink, says physical activity plays an important role in preventing recurrent stroke but many stroke survivors may have limited mobility.
“This is where yoga and tai chi are so helpful. They are gentle, movement-based MBIs which help people focus — a state of mind which stroke survivors often lose — and be active at the same time,” Dr Immink says.
The researchers analysed 26 studies published between 1985 and 2017 which examined how yoga and tai chi moderated key stroke risk factors, including blood pressure, cholesterol, diabetes, atrial fibrillation, smoking and alcohol consumption, obesity, anxiety and depression.
UniSA Dean of Health Research, Professor Susan Hillier, says there is increasing evidence that MBIs can be an effective and noninvasive way of reducing hypertension — the biggest stroke risk factor.
“Some evidence suggests that MBIs such as yoga and tai chi regulate blood pressure by teaching people to breathe deeply, balancing and stabilising their autonomic nervous system and lowering their heart rate,” Prof Hillier says.
The stroke specialist says nearly one third of adults around the world suffer from high blood pressure, with 23 million additional strokes projected in the next 12 years.
“Survivors of stroke are at an increased risk of another one — 43 per cent likely within 10 years, 32 per cent within five years and 16 per cent within one year — so it is important we find interventions to help reduce the major risk factors,” she says.
Apart from reducing blood pressure, the research shows that MBIs can help improve diabetics’ health by increasing blood and oxygen supply to the tissues, helping to produce insulin, and boosting anti-oxidants.
Story Source: University of South Australia. “Stroke survivors and those at risk urged to focus on yoga and tai chi.” ScienceDaily. ScienceDaily, 5 November 2018. <www.sciencedaily.com/releases/2018/11/181105105417.htm>.
Nov 3, 2018
Published first on ScienceDaily.com
About 6 million Australians aged 18 years and over have high blood pressure. Of these, more than two thirds had uncontrolled or unmanaged high blood pressure (not taking medication), representing 4 million adult Australians.
High blood pressure, or hypertension, is suggested to be one of the leading risk factors for heart disease.
The process in which high blood pressure causes heart disease is not completely understood.
But now scientists at the Baker Heart and Diabetes Institute have found that high blood pressure caused by specific signalling from the brain promotes heart disease by altering stem cells with the bone marrow.
The results, published in Haematologica demonstrate how an overactive sympathetic nervous system that causes elevated blood pressure can instruct bone marrow stem cells to produce more white blood cells that clog up blood vessels.
The Baker Institute’s Head of Haematopoiesis and Leukocyte Biology, Associate Professor Andrew Murphy says the findings represent a new era of heart disease research.
“Hypertension is a major, independent risk factor of atherosclerotic cardiovascular disease, but we need more information to determine how it is resulting in heart attacks and strokes,” said Associate Professor Murphy.
Atherosclerotic cardiovascular disease is a build-up of cholesterol plaque in the walls of arteries, causing obstruction of blood flow.
“We now know that significance changes in the immune system contributes significantly to heart disease,” he said. “We aimed to determine how the sympathetic nervous system through the brain directly promotes atherosclerosis in the setting of hypertension.”
“We have discovered that this form of high blood pressure, often associated with stress, causes changes within the bone marrow leading to increased white blood cells circulating though our vessels. This is significant as the general view of hypertension is that it is mainly a disease of the blood vessels, which means other heart damaging events are missed.”
The team is now exploring the specific molecules involved, which may shed light as to why some current therapies are ineffective. They also suggest that managing stress, anxiety and pain are likely to help in controlling this form of hypertension and the effects it has on the body’s bone marrow stem cells.
Story Source: Baker Heart and Diabetes Institute. “Dangerous blood pressure caused by specific signalling in the brain.” ScienceDaily. ScienceDaily, 1 November 2018. <www.sciencedaily.com/releases/2018/11/181101085147.htm>.
Nov 1, 2018
Stroke is No. 1 cause of mortality in women in most countries. Some people say it’s because of statistics- we live longer than men. Does this mean that nothing can be done about it?
Jelena Misita, SAFE Awareness and Advocacy Manager had an interview with Valeria Caso, MD, PhD, FESO. Valeria Caso is a stroke neurologist at the University of Perugia Stroke Unit and she is a past ESO President.
Please click on the banner below to access the podcast.
Nov 1, 2018
Brussels, 1st November 2018 – The eLearning Module 5 of the Stroke Support Organisation Faculty Tool (SSOFT) is published today at the following address www.ssoft.info.
SSOFT’s fifth module focuses on health and care systems and how to influence key decision makers within them to make positive changes around stroke prevention, care and treatment. The module is broken down in to seven bite-size sections, which covers:
5.1 – Health & care systems
5.2 – Influencing health & care systems
5.3 – How decisions are made and who makes those decisions
5.4 – The impact of guidelines within the health & care systems
5.5 – Identifying existing evidence
5.6 – Using case studies and data
5.7 – Life after stroke
In Module 5, using a combination of theory and practice, SSOFT demonstrates how to gain an understanding of existing health and care systems, allowing the identification of where key decisions are happening and who is making them. Through a better understanding of these systems Stroke Support Organisations (SSOs) can work with the key decision makers to advocate for improved stroke care, treatment and long term support. This can be achieved by using existing evidence and data, as well as the voices of stroke survivors.
SSOs have been at the heart of the development of this tool. For newer or smaller organisations, the information in the tool will provide knowledge that will help them to build and grow. For larger organisations, SSOFT will enable them to support their communities and other stroke professionals across Europe as they grow their communities and add more voices to their movement/arguments for change.
This tool is also for anyone who is interested in knowing more about what an SSO is, how to start and develop one and how to make it sustainable.
For those interested in using this innovative eLearning platform we would encourage them to visit the SSOFT website www.ssoft.info
About SSOFT
SSOFT is an innovative online eLearning advocacy tool being developed by Stroke Alliance for Europe (SAFE), in partnership with the European Stroke Organisation (ESO).
This online learning platform provides knowledge and training on how the creation of effective advocacy activities and campaigns to deliver positive change at a local and national level on stroke prevention, treatment and care. The eLearning platform will include six modules that provide information on:
Module 1: Stroke Support Organisations (SSOs)
Module 2: Making Change Happen
Module 3: Use of Evidence
Module 4: Role of Patient Voice
Module 5: Health & Care System Advocacy
Module 6: Public Advocacy
The modules and learning environment is accessible via the SSOFT website through a simple registration process. Visitors to the website can also learn more about SSOFT, SAFE and ESO, find their nearest SAFE Stroke Support Organisation (SSO) as well as hear from SAFE members about their experiences.
For more information, please send an email ssoft@safestroke.eu or visit www.ssoft.info
Acknowledgments
SAFE would like to take this opportunity to thank and acknowledge the contributions made by those who have helped in the development of SSOFT and module 5.
- Stroke Alliance for Europe Board, who have been involved at every stage of development of this module.
- The Peer Reviewers for module 5:
- Stiftung Deutsche Schlaganfall-Hilfe (Dr Markus Wagner)
- Hellenic Alliance/Action for Stroke Support Organization (Dr Hariklia Proios)
- Australian Stroke Association (Ms Sharon McGowan)
- Experience, Participation and Equalities, NHS England (Dr Neil Churchill)
- Our members who have shared their experiences and knowledge in the video interviews used within the module:
- Francesca Romana Pezzella – ALICe, Italy
- Markus Wagner – Stiftung Deutsche Schlaganfall-Hilfe, Germany
- Jon Barrick – Stroke Alliance for Europe (SAFE)
- Monique Lindhout – Hersenletsel, Netherlands
- Adam Siger – Fundacja Udaru Mózgu, Poland
- Hrvoje Jurlina – HDPMU Croatian Stroke Society, Croatia
- Our member and partner organisations who have collaborated in the development of the module content:
- World Stroke Organization
- European Stroke Organisation.
- And all those who participated in the User Acceptance Testing of module 5.
We would also like to thank the project sponsor Bayer Healthcare who have supported this project through an education grant.
About SAFE
The Stroke Alliance for Europe (SAFE) a non-profit-making organisation formed in 2004. It is the voice of stroke patients in Europe, representing a range of patient groups from 30 European countries.
SAFE’s goal is to decrease the number of strokes in Europe by advocating for better prevention, access to adequate treatment, post-stroke care and rehabilitation.
For more information about SAFE, please visit www.safestroke.eu
Oct 29, 2018
This article was provided by World Stroke Organisation
Today on World Stroke Day, October 29th the World Stroke Organization, is calling for urgent action and investment to address the growing burden of stroke and circulatory diseases globally.
Prof Michail Brainin
Photo credit WSO
Highlighting the disappointing outcome of the recent UN High Level Meeting on Non-Communicable Diseases (NCDs) the WSO President, Prof Michael Brainin said, ‘We know that we 80% of strokes could be prevented by addressing a small number of risk factors, including hypertension, diet, smoking and lack of exercise. We also know that action on prevention would also contribute to a massive scale reduction in heart disease, cancer and diabetes.’
‘The impact of stroke on individuals, families and society as a whole is devastating. Stroke survivors can face significant impairment of movement, speech, cognition alongside debilitating psychological, social and financial problems.
‘With this knowledge, the current lack of political will and investment is cannot be easily comprehended, especially when you consider the cost of such inaction. While 5.5 million people die as a result of stroke each year, there are 80m stroke survivors in the world, many of whom live with some form of disability or impairment. While the costs to individuals is incalculable, the cost to society is astronomical.’
A recent policy document ‘Driving Sustainable Action for Circulatory Health’ published by the WSO and its partners in the Global Coalition for Circulatory Health, has calculated the global cost of circulatory diseases, including stroke, at US$957 Billion in 2015. On current projections this figure is set to rise to US$1044 Billion by 2030. The white paper sets out four key areas for action that, if enacted, would ensure delivery of global goals on disease reduction which are driving the rise in direct and indirect costs of NCDs. These include legislative interventions that:
1. Deliver policies and programmes to address tobacco, alcohol and unhealthy foods, promote clean air and deliver a built environment that fosters safe physical activity.
2. Ensure access to affordable, quality-assured essential medicines, delivered by adequately trained staff, including access to multi-therapy treatments.
3. Mobilise sufficient resources to combat non-communicable diseases including stroke. The taxation of unhealthy products such as alcohol, tobacco, unhealthy foods and non-alcoholic beverages (such as sugar-sweetened beverages) would generate revenues that could be directed to further prevention and control of circulatory diseases at global and national levels.
4. Put in place reliable, simple, and fit-for- purpose surveillance systems for monitoring the burden of stroke and the prevalence of NCD risk factors and treatment of stroke at national and global levels.
Prof Brainin concluded ‘At the recent UN High Level Meeting on NCDs in New York, governments delivered a weak response to a global crisis and agreed to wait 7 years before reviewing progress. In that time another 38.5 million people will die of stroke. We can’t wait until 2025 to calculate our losses, we need strong leadership and bold action to save lives now.’
Oct 29, 2018
Today is World Stroke Day, October 29th. Though stroke may feel isolating, there are millions of survivors in the world. Stroke recovery is a community effort, and there needs to be a more clearly defined pathway from prevention to rehabilitation.
Taking that into account, SAFE is proud to announce the publishing of the Stroke Action Plan for Europe 2018-2030. This document is a result of collaborative work between SAFE and European Stroke Organisation (ESO), being an intersection and a point of confluence for large experiences coming from SAFE’s members, stroke survivors and patient advocates from one side and medical experts, specialised in stroke and stroke related research.
“With this great collaboration we are trying to make sure more attention is paid to the whole stroke care pathway. Fatigue, long-term pain, finance, work or unemployment, relationships, aphasia- these things are usually not in front of mind for many medics or politicians and healthcare decision makers. Therefore, the addition of Life After Stroke domain as one of the Stroke Action Plan’s priorities is an important step forward. SAFE is working with ESO to ensure that we jointly engage with politicians and decision makers until the whole action plan is being implemented” said Jon Barrick, SAFE President.
This year, around 610,000 people in the European Union will have a stroke, and, although the figures are patchy, at least 170,000 people in non-EU European countries will have one. That is more than one stroke a minute. Their stroke could be devastating – leading to death or life-long disability, shattering their lives and those of their loved ones. Those who survive their stroke will join the millions of stroke survivors across Europe who live with the health, social and financial impacts.
“Long term commitment and attention to the needs and rights of stroke survivors and their caregivers will contribute to better health and wellbeing, outcomes, increase independence and reduce demand on healthcare, social and welfare systems” concluded Barrick.
The popular version of the Stroke Action Plan for Europe 2018-2030 can now be downloaded from HERE.
The scientific version of this document is also available starting from today and can be downloaded from the following LINK.
Oct 26, 2018
On Monday, October 29th stroke support organisations from around the world will create a global moment to demonstrate that there is life after stroke – that a stroke may bring you down but that it’s possible to get #UpAgainAfterStroke.
It is estimated that there are around 80 million stroke survivors around the world each one facing many challenges of daily living after having had a stroke. Stroke survivors face many obstacles and the scale of this is dependent on where they live, their socioeconomic status and the severity of their stroke.
Despite these obstacles on World Stroke Day 2018 we want to focus the world’s attention on what unites stroke survivors and caregivers – their resilience, their capacity to build on the things that stroke can’t take away and their determination to keep going on their journey of recovery.
For every stroke survivor, Getting Up Again After Stroke takes commitment. Building support networks with other stroke survivors, sharing stories of survival and recovery can help people stay hopeful and focused on progressing.
At the same time, caring for someone who has had a stroke can be demanding and many of the relationships that bind us change. It is understandable that carers need help too.
Policy-makers need to understand that long term commitment and attention to the needs and rights of stroke survivors and their caregivers will contribute to better health and wellbeing, outcomes, increase independence and reduce demand on healthcare, social and welfare systems.
SAFE member organisations from 30 European countries are preparing a series of events to mark World Stroke Day this year, under an overarching theme #UpAgainAfterStroke.
Find your country’s organisation HERE and help us raise stroke awareness for this World Stroke Day.
Stroke Alliance for Europe with all our members from 30 European countries, proudly stands with the stroke survivors and their families on October 29th, World Stroke Day.
