Collecting occupational data for a national stroke study cohort: Methodology of the NIOSH-regards study

Background The Life’s Simple 7 (LS7) metric incorporates health behaviors (body mass index, diet, smoking, physical activity) and health factors (blood pressure, cholesterol, glucose) to estimate an individual’s level of cardiovascular health. The association between cardiovascular health and incident hypertension is unresolved. Hypertension’s threshold was recently lowered and it is unclear if better cardiovascular health is associated with lower risk of incident hypertension with the updated threshold or in a multirace cohort. We sought to assess the association between better LS7 score and risk of incident hypertension among Black and White adults using a 130/80 mm Hg hypertension threshold. Methods and Results We determined the association between LS7 metric and incident hypertension in the REGARDS (Reasons for Geographic and Racial Disparities in Stroke) study, including participants free of baseline hypertension (2003–2007) who completed a second visit between 2013 and 2016. Hypertension was defined as systolic/diastolic blood pressure ≥130/80 mm Hg or antihypertensive medication use. Each LS7 component was assigned 0 (poor), 1 (intermediate), or 2 (ideal) points. We generated a 14‐point score by summing points. Among 2930 normotensive participants (20% Black, 80% White), the median (25th–75th percentiles) LS7 total score was 9 (8–10) points. Over a median follow‐up of 9 years, 42% developed hypertension. In the fully adjusted model, each 1‐point higher LS7 score had a 6% lower risk of incident hypertension (risk ratio, 0.94 per 1 point; 95% CI, 0.92–0.96). Conclusions Better cardiovascular health was associated with lower risk of incident hypertension using a 130/80 mm Hg hypertension threshold among Black and White adults.

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Race-Sex Disparities in Cardiovascular Mortality for Participants with Chronic Obstructive Pulmonary Disease (COPD) in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study Cohort

10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1125 ◽

2021 ◽

Author(s):

J.K. Krishnan ◽

M. Rajan ◽

M.K. Han ◽

D.M. Mannino ◽

F.J. Martinez ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Racial Differences ◽

Cardiovascular Mortality ◽

Chronic Obstructive ◽

Study Cohort ◽

Obstructive Pulmonary Disease ◽

Sex Disparities ◽

Regards Study

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Sex Differences in Stroke Survival: 10-Year Follow-up of the Copenhagen Stroke Study Cohort

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2005.06.002 ◽

2005 ◽

Vol 14 (5) ◽

pp. 215-220 ◽

Cited By ~ 23

Author(s):

Morten Nonboe Andersen ◽

Klaus Kaae Andersen ◽

Lars Peter Kammersgaard ◽

Tom Skyhøj Olsen

Keyword(s):

Sex Differences ◽

Study Cohort ◽

Stroke Study ◽

Copenhagen Stroke Study

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Abstract P254: Willingness to Restart Statins: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.135.suppl_1.p254 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Gabriel S Tajeu ◽

Lisandro D Colantonio ◽

Rikki M Tanner ◽

Keri L Monda ◽

Ricardo Dent ◽

...

Keyword(s):

Risk Factors ◽

Side Effects ◽

Racial Differences ◽

Statin Treatment ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Stroke Study ◽

History Of ◽

Regards Study ◽

Or History

Introduction: Many patients who discontinue statins due to side effects can restart treatment without the return of side effects. However, statin rechallenge is often met with resistance. Statins are associated with a larger absolute cardiovascular disease (CVD) risk reduction among high risk individuals, but it is unclear whether individuals with higher CVD risk are more willing to be rechallenged. Methods: Between 2014 and 2016, 12,604 participants in theREasons for Geographic and Racial Differences in Stroke study completed a study examination and a questionnaire about their experiences with statins. Of 6,947 participants who reported ever having taken a statin, this analysis included the 688 (9.9%) who reported having discontinued treatment due to side effects and who were not currently taking a statin. We asked participants whether they would be willing to restart a statin, and among those who answered no, we asked whether they were willing to restart at a lower dose or less frequently. Data from the study examination were used to define CVD risk factors and 10-year predicted CVD risk was calculated using the Pooled Cohort risk equations. Results: Participant mean age was 62.4 years, 29.6% were African American, and 66.4% were women. Overall, 26.0% (n=179) of participants were willing to be rechallenged with a statin (Table) . After adjustment for sociodemographic characteristics, older age, cigarette smoking, hypertension, diabetes, or history of CVD were not associated with an increased willingness to be rechallenged with a statin (Table) . Higher 10-year predicted CVD risk was also not associated with willingness to be rechallenged. Conclusions: Over a quarter of participants who discontinued statin treatment due to side effects were willing to be rechallenged. The presence of CVD risk factors and higher predicted CVD risk were not associated with increased willingness to be rechallenged with a statin.

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Sekundärprävention nach ischämischem Schlaganfall

Praxis ◽

10.1024/0369-8394.92.5.168 ◽

2003 ◽

Vol 92 (5) ◽

pp. 168-178

Author(s):

Baumgartner ◽

Georgiadis

Keyword(s):

Recurrent Stroke ◽

Facteurs De Risque ◽

Heart Protection Study ◽

Accident Vasculaire Cérébral ◽

Study Progress ◽

Intervention Chirurgicale ◽

Heart Protection ◽

Stroke Study

Ce travail de revue présente la prévention secondaire des accidents vasculaire cérébraux par le traitement des facteurs de risque vasculaire, les inhibiteurs de l'agrégation plaquettaire, l'anticoagulation ou les thérapies endovasculaires. Deux études publiées récemment (PROtection aGainst Recurrent Stroke Study (PROGRESS) et la Heart Protection Study (HPS) ont pour la première fois pu démontrer l'efficacité d'un traitement contre l'hypertension et par statines dans la prévention secondaire après un accident vasculaire cérébral. PROGRESS a montré que la combinaison de perindopril et d'indapamide permet de réduire de 43% la survenue d'accidents vasculaires cérébraux ischémiques et hémorragiques chez les patients hypertendus ou normotendus alors que HPS a mis en évidence une diminution de 20% des accidents vasculaires cérébraux ischémiques chez les patients avec des taux sériques normaux ou élevés de cholestérol. Les sténoses carotidiennes symptomatiques avec un resserrement distal > ou égal à 70% sont opérées par endartérectomie; en cas de sténose distale de 50–69% une décision individuelle est prise; une endartérectomie n'est pas indiquée en cas de sténose < 50%. Les patients chez lesquels une source cardiaque d'embolie est mise en évidence doivent être anticoagulés (INR 2.5, intervalle: 2–3) à l'exception des myxomes cardiaques et des endocardites bactériennes. Si aucune intervention chirurgicale sur une artère cérébrale n'est indiquée ou si le patient ne doit pas être anticoagulé, on traite par un inhibiteur de l'agrégation plaquettaire: 100 mg d'aspirine ou la combinaison d'aspirine et de dipyridamol sont le traitement de choix. En cas de récidive d'ischémie sous aspirine ou d'intolérance à l'aspirine, le clopidogrel est prescrit. Comme alternative au clopidogrel en cas de récidive d'ischémie, une anticoagulation (INR 2.0, intervalle: 1.5–2.5) peut être prescrite.

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Diagnostic Value of a Carpal Tunnel Corticosteroid Injection in Patients with Negative Electrodiagnostic Studies

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1717830 ◽

2020 ◽

Author(s):

Brian M. Katt ◽

Casey Imbergamo ◽

Fortunato Padua ◽

Joseph Leider ◽

Daniel Fletcher ◽

...

Keyword(s):

Carpal Tunnel ◽

Corticosteroid Injection ◽

Carpal Tunnel Release ◽

False Negative ◽

False Negative Rate ◽

Signs And Symptoms ◽

Diagnostic Value ◽

Symptom Improvement ◽

Study Cohort ◽

Chi Square Analysis

Abstract Introduction There is a known false negative rate when using electrodiagnostic studies (EDS) to diagnose carpal tunnel syndrome (CTS). This can pose a management dilemma for patients with signs and symptoms that correlate with CTS but normal EDS. While corticosteroid injection into the carpal tunnel has been used in this setting for diagnostic purposes, there is little data in the literature supporting this practice. The purpose of this study is to evaluate the prognostic value of a carpal tunnel corticosteroid injection in patients with a normal electrodiagnostic study but exhibiting signs and symptoms suggestive of carpal tunnel, who proceed with a carpal tunnel release. Materials and Methods The group included 34 patients presenting to an academic orthopedic practice over the years 2010 to 2019 who had negative EDS, a carpal tunnel corticosteroid injection, and a carpal tunnel release. One patient (2.9%), where the response to the corticosteroid injection was not documented, was excluded from the study, yielding a study cohort of 33 patients. Three patients had bilateral disease, yielding 36 hands for evaluation. Statistical analysis was performed using Chi-square analysis for nonparametric data. Results Thirty-two hands (88.9%) demonstrated complete or partial relief of neuropathic symptoms after the corticosteroid injection, while four (11.1%) did not experience any improvement. Thirty-one hands (86.1%) had symptom improvement following surgery, compared with five (13.9%) which did not. Of the 32 hands that demonstrated relief following the injection, 29 hands (90.6%) improved after surgery. Of the four hands that did not demonstrate relief after the injection, two (50%) improved after surgery. This difference was statistically significant (p = 0.03). Conclusion Patients diagnosed with a high index of suspicion for CTS do well with operative intervention despite a normal electrodiagnostic test if they have had a positive response to a preoperative injection. The injection can provide reassurance to both the patient and surgeon before proceeding to surgery. Although patients with a normal electrodiagnostic test and no response to cortisone can still do well with surgical intervention, the surgeon should carefully review both the history and physical examination as surgical success may decrease when both diagnostic tests are negative. Performing a corticosteroid injection is an additional diagnostic tool to consider in the management of patients with CTS and normal electrodiagnostic testing.

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