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The study looked at a sample of data from some U.S. stroke hospitalizations. From 2003 to 2004 in this sample, more than 141,000 people from 18 to 65 were admitted to hospitals for stroke. By 2011 to 2012, that number had risen to more than 171,000, researchers found.
“Our results stress the importance of prevention of stroke risk factors in younger adults,” said lead author Dr. Mary George. She’s a senior medical officer with the U.S. Centers for Disease Control and Prevention’s division of heart disease and stroke prevention.
“Young adults, ages 18 to 54, are experiencing a small but sustained increase in stroke and in the prevalence of traditional stroke risk factors, such as high blood pressure, diabetes, high cholesterol, tobacco use and obesity,” George said.
Up to 80 percent of strokes are thought to be preventable, she said.
George said the study’s findings “should prompt a sense of urgency to promote and engage young adults in practicing healthy behaviors, such as exercising, eating a healthy diet that includes plenty of fruits and vegetables, avoiding smoking, and maintaining a healthy weight.”
The impact of a stroke is significant at any stage of life, she said.
But George added, “It is uniquely complex when younger adults in the midst of careers, serving as wage earners and caregivers, may suffer disability that can impact their lives and the lives of family members and loved ones.”
Stroke is the fifth leading cause of death in the United States. Each year stroke kills more than 130,000 Americans. Stroke is also a leading cause of disability, George said.
To study trends in stroke, the researchers used a database of some U.S. hospital stays gleaned from billing records. The 2003-2004 data included more than 362,000 stroke hospitalizations. The 2011-2012 information included nearly 422,000 stroke hospitalizations.
There are two types of stroke: ischemic and hemorrhagic. An ischemic stroke, sometimes called a brain attack, is a stroke that occurs when a blood clot blocks the blood supply to the brain. Hemorrhagic strokes are caused by bleeding in the brain from a ruptured blood vessel.
Men between 35 and 44 years old saw a striking increase of 41.5 percent in hospitalizations from ischemic stroke over the two study periods.
The researchers found that the rate of hemorrhagic strokes remained basically stable during the study period. The one exception was in the 45 to 54 age group. There was a slight decline in hemorrhagic strokes for men and blacks in that age group, the study showed.
The researchers think an increase in stroke risk factors, such as high blood pressure, diabetes, high cholesterol, obesity and smoking, are behind the rise in strokes among younger adults.
During the study, the percentage of people with three or more stroke risk factors roughly doubled for all age groups.
“Preventing and controlling stroke risk factors among young adults can save lives, reduce disability, decrease health care costs and improve the quality of life for tens of thousands of people and their families,” George said.
The study was published online April 10 in the journal JAMA Neurology.
One specialist questioned the use of billing data to uncover trends in stroke and isn’t sure a real increase in strokes among younger adults is occurring.
“The systems for counting stroke in the United States are extremely limited,” said Dr. James Burke, an assistant professor of neurology at the University of Michigan.
“Credible alternatives may explain what appears to be an increase in stroke among young men and women, but is not,” said Burke, who co-wrote an accompanying journal editorial.
“MRIs are more widely used, which can lead to an increase in diagnosis of stroke,” he said.
“MRIs are being used for all kinds of things, and so when you put lots and lots of people in MRI scanners, for example for headaches, we will find asymptomatic brain injury that is stroke-like, and how much classifying of these as stroke is not clear,” Burke said.
In addition, the United States doesn’t have extensive databases that track patients and medical conditions, he said.
“Our ability to make strong conclusions is surprisingly limited since we don’t have national health data on everybody. When we are making these measurements, we are looking at a small chunk of the population,” Burke said.
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A Harvard University study published in journal Neurology found those who exercised “vigorously” three times a week or more prior to a stroke were more likely to be independent after the medical emergency compared to those who were inactive.
“We also found that a person’s body mass index (BMI) was not a factor in predicting their level of disability after stroke,” said lead author Dr Pamela Rist.
Body mass index is a measure of a person’s body fat based on their height and weight. Having too much body fat may be a risk to a person’s health.
For the study, researchers followed more than 18,000 people who were initially stroke-free for an average of 12 years.
Participants were interviewed every other year about their ability to do basic activities and were also asked for their height, weight and whether they participated in vigorous physical activity or exercise.
Vigorous physical activity was defined as participating in sports, heavy housework or a job that required physical labour.
During the study, 1,374 of the participants had a stroke and survived and 479 people had a stroke and died before the next round of interviews.
Of those who did not have a stroke, 45 per cent were physically active, compared to 43 per cent of those who had a stroke and survived.
Among the stroke survivors, those who were physically inactive were 18 per cent less likely to be taking care of their basic activities such as bathing on their own three years after stroke than those who exercised regularly.
They were also 16 per cent less likely to be taking care of more complex activities such as managing money on their own.
“Our study was able to show that being physically inactive before stroke predicts a higher risk of being dependent both before and after stroke,” Dr Rist said.
“Research is needed to look into whether more intense activity could improve stroke outcomes and whether people can change their activity patterns to improve stroke outcomes.”
Study: Marijuana use associated with increased risk of stroke! Using marijuana raises the risk of stroke and heart failure even after accounting for demographic factors, other health conditions and lifestyle risk factors such as smoking and alcohol use, according to new national research.
Coming at a time when marijuana, medically known as cannabis, is on track to become legal for medical or recreational use in more than half of U.S. states, this study sheds new light on how the drug affects cardiovascular health. While previous marijuana research has focused mostly on pulmonary and psychiatric complications, the new study is one of only a handful to investigate cardiovascular outcomes.
“Like all other drugs, whether they’re prescribed or not prescribed, we want to know the effects and side effects of this drug,” said Aditi Kalla, MD, Cardiology Fellow at the Einstein Medical Center in Philadelphia and the study’s lead author. “It’s important for physicians to know these effects so we can better educate patients, such as those who are inquiring about the safety of cannabis or even asking for a prescription for cannabis.”
The study drew data from the Nationwide Inpatient Sample, which includes the health records of patients admitted at more than 1,000 hospitals comprising about 20 percent of U.S. medical centers. Researchers extracted records from young and middle-aged patients—age 18-55 years— who were discharged from hospitals in 2009 and 2010, when marijuana use was illegal in most states.
Marijuana use was diagnosed in about 1.5 percent (316,000) of more than 20 million health records included in the analysis. Comparing cardiovascular disease rates in these patients to disease rates in patients not reporting marijuana use, researchers found marijuana use was associated with a significantly increased risk for stroke, heart failure, coronary artery disease and sudden cardiac death.
Marijuana use was also linked with a variety of factors known to increase cardiovascular risk, such as obesity, high blood pressure, smoking and alcohol use. After researchers adjusted the analysis to account for these factors, marijuana use was independently associated with a 26 percent increase in the risk of stroke and a 10 percent increase in the risk of developing heart failure.
“Even when we corrected for known risk factors, we still found a higher rate of both stroke and heart failure in these patients, so that leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects,” Kalla said. “More research will be needed to understand the pathophysiology behind this effect.”
Research in cell cultures shows that heart muscle cells have cannabis receptors relevant to contractility, or squeezing ability, suggesting that those receptors might be one mechanism through which marijuana use could affect the cardiovascular system. It is possible that other compounds could be developed to counteract that mechanism and reduce cardiovascular risk, Kalla said.
Because the study was based on hospital discharge records, the findings may not be reflective of the general population. The study was also limited by the researchers’ inability to account for quantity or frequency of marijuana use, purpose of use (recreational or medical), or delivery mechanism (smoking or ingestion).
Kalla suggested that the growing trend toward legalization of marijuana could mean that patients and doctors will become more comfortable speaking openly about marijuana use, which could allow for better data collection and further insights into the drug’s effects and side effects.
The research was scheduled for presentation at the American College of Cardiology’s 66th Annual Scientific Session.
Aphasia is a condition that occurs post-stroke and results in a loss of speech. Research suggests that it can be compensated for by the right side of the brain. Previous research suggested that the right side of the brain actually interfered with recovery post-stroke, but the new findings suggest that the back, right side of the brain can actually aid in speech recovery.The study examined grey matter volume and its role in speech and how speech can be recovered. The researchers found that patients who regained their voice post-stroke also had more grey matter volume in the back right hemisphere of the brain.
Senior author, Peter Turkeltaub, M.D., Ph.D., said, “Over the past decade, researchers have increasingly suggested that the right hemisphere interferes with good recovery of language after left hemisphere strokes. Our results suggest the opposite – that right hemisphere compensation improves recovery.”
Speech and language loss, known as aphasia, occurs in one-third of stroke patients and they never fully regain it back.
In a group of 32 stroke survivors whose left hemisphere was affected, grey matter volume in the back right hemisphere led to greater success of recovering speech and language. The stroke survivors were compared to 30 other individuals as a control group.
Furthermore, those with recovered speech areas had a larger right hemisphere. Dr. Turkeltaub added, “This indicates growth in these brain areas that relates to better speech production after a stroke.”
Aphasia is caused by brain damage, most commonly a result of stroke. There are four different aphasia types: expressive, receptive, global and nominal. Expressive aphasia is when a person knows what they want to say but are unable to find the words to express themselves. Receptive aphasia is when a person hears someone or reads words but cannot understand what they just heard or read. Global aphasia is when there is widespread damage to language and the person cannot speak or understand language. Lastly, nominal aphasia is when a person cannot use the right terms for objects, people, places or events – this is the least severe form.
The type of aphasia a person has can determine the symptoms they experience. Common symptoms of aphasia include:
If brain damage caused by stroke is mild, language recovery may be possible through speech and language therapy. Therapy is most effective when administered early on – research has supported the idea that speech therapy should occur soon after the brain injury has occurred.
Therapy may also be effective in group settings, where communication skills can be practiced in a safe environment free of judgment. Also, speech therapy may involve the use of computers to assist in the re-learning of verbs and word sounds.
Lastly, although there are no proven medications that can restore language in aphasia, they continue to be studied.
These brain cells grew new connections after exposure to GDF10. Image credit: UCLA
Written by Catharine Paddock PhD
A study led by researchers from the University of California-Los Angeles (UCLA) and published in Nature Neurologyidentifies a molecule called growth differentiation factor 10 (GDF10) that signals brain tissue to form new connections following a stroke.
The senior author of the study is neurologist and neuroscientist S. Thomas Carmichael, professor and vice chair for research and programs in UCLA’s department of neurology. He and his colleagues hope their findings will lead to new treatments to help patients recover brain function following a stroke.
Prof. Carmichael says their study is the first to identify that GDF10 has a function in the adult brain. He explains the importance of the finding:
“The brain has a limited capacity for recovery after stroke. Most stroke patients get better after their initial stroke, but few fully recover. If the signals that lead to this limited recovery after stroke can be identified and turned into a treatment, then it might be possible to enhance brain repair after stroke.”
The researchers started by searching for molecules that are prevalent in the brain following a stroke and listing all the genes that are switched on or off (they had already identified them in earlier work).
This was how GDF10 emerged as a possible trigger for brain repair, so the team investigated it more closely by looking at how it behaves in brain cells in the Petri dish and in animals.
The researchers found that GDF10 appears to encourage brain cells to make new connections. Prof. Carmichael comments:
“We found that GDF10 induces new connections to form in the brain after stroke, and that this mediates the recovery of the ability to control bodily movement.”
Fast facts about stroke
After identifying the signaling systems that control the process of making new connections, the team then pinpointed the molecules that GDF10 switches on and off in brain cells after a stroke.
They compared what happens to the RNA in these cells to what happens to the RNA in similar cells during brain development and learning, and to the RNA in brain cells of people with other types of disease.
RNA (ribonucleic acid) is an essential molecule that helps to pass the genetic information held in DNA onto proteins. It is also important for protein synthesis and gene regulation.
The researchers found that GDF10 controls a unique group of molecules that help brain tissue recover following a stroke.
They suggest this process of brain tissue repair following a stroke is unique and not simply a reactivation of molecules involved in brain development.
The researchers then explored the effect of GDF10 on brain areas linked to limb control. They mapped brain connections in this area in animals (rats and mice) that were given GDF10 following a stroke, in animals that suffered stroke but did not receive GDF10, in healthy animals and in animals that were given less GDF10 following a stroke.
Prof. Carmichael describes what they found:
“The results indicated that GDF10 normally is responsible for the very limited process of the formation of new connections after stroke. Delivering more GDF10 markedly enhances the formation of new connections and does so mostly in a specific brain circuit. The formation of connections in this circuit with GDF10 administration significantly enhanced recovery of limb control after stroke.”
He and his colleagues are now looking for a small molecule that could trigger GDF10 signaling and possibly lead to a drug to improve recovery after stroke.
Meanwhile, Medical News Today recently learned of new research that shows high-stress jobs can lead to stroke, especially in women. Reporting in the journal Neurology, researchers from Southern Medical University in Guangzhou, China, defined high-stress jobs as being occupations where demands are high and control is low – such as that experienced by waitresses and nursing aides.