Long-term depression is a stroke risk factor

2011 ◽  
Vol 23 (6) ◽  
pp. 292-296 ◽  
Author(s):  
Emel Kocer ◽  
Abdulkadir Kocer ◽  
Yıldız Degirmenci ◽  
Mehmet Eryılmaz
Keyword(s):  
Risk Factor ◽  
Stroke Risk ◽  
Stroke Patients ◽  
Long Term Depression ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Stroke Population ◽  
Time Period ◽  
Brain Stroke

Kocer E, Kocer A, Degirmenci Y, Eryılmaz M. Long-term depression is a stroke risk factor.Background and Aim: Only a few studies have evaluated depression prevalence in pre-stroke period in comparison to controls. We investigated this association based on a hospitalised stroke population.Methods: One hundred and forty-eight stroke patients were evaluated. The presence of depression was compared with those of 100 healthy controls without stroke, from the same region. Depression was accepted as present or not present after history and clinical evaluation according to Diagnostic and Statistical Manual of Mental Disorders-IV. Socio-demographic variables, other stroke risk factors and the time of diagnosis of depression (how many year or month they got depression) were recorded.Results: Gender and mean age of patients and controls were similar in comparison. Depression was diagnosed in 27 patients and 24 controls (p > 0.05). The time period passed after diagnosis of depression was longer in stroke patients in comparison to controls (p < 0.001).Conclusions: The risk of stroke should be considered in elderly with long-term depression. This indicates that treatment of depression is another factor which should be considered in prevention of brain stroke.

Abstract 3384: Effectiveness of the FAST Program Targeting African American Middle School Teachers

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Elaine T Miller ◽  
Keith King ◽  
Rosemary Miller
Keyword(s):  
Middle School ◽  
African American ◽  
Risk Factor ◽  
Middle School Teachers ◽  
Self Efficacy ◽  
Stroke Risk ◽  
Warning Signs ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors

Significance and Purpose: During the school year, teachers interact with middle students almost half of their waking hours and have a unique opportunity to positively affect their own health as well as their students. The purpose of this pilot study performed in a predominantly African American middle school was to evaluate the effectiveness of the 3 month long FAST Stroke Education Program designed for teachers that used Social Cognitive Theory as the underlying framework. The program objectives were to: (1) increase the teachers’ knowledge of the major stroke risk factors, stroke warning signs, and treatment seeking behaviors (call 911); (2) improve the teachers self-efficacy related to improving one of their own modifiable stroke risk factors; and (3) achieve their self-identified goal to reduce a modifiable stroke risk factor. Methodology: After obtaining consent, the teachers received a pretest survey that assessed their stroke knowledge and self-efficacy related to stroke. Following this pretest, the teachers received a 45 minute educational intervention that included interaction with a stroke survivor and taking an immediate posttest. As part of this session, the teachers also identified one personal objective for the next 3 months (i.e., exercise 30 minutes 3 times/day) and listed 2-3 feasible actions to achieve this objective. Six weeks later, they were mailed their objective, action plan, and stroke related educational materials in a self-addressed envelope. At three months, teachers received a long-term posttest that also determined if they had achieved their self-identified modifiable stroke risk factor. Findings: The study’s convenience sample consisted of 29 full-time teachers who were mostly male (n = 18, 62%) and African American (n=19, 65.5%). Risk factor knowledge scores were significantly higher at immediate posttest than at pretest, t = 2.25, p = .03 and was maintained at 3 months. Regarding stroke warning signs, there was a significant difference between pretest and posttest with a t=2.52, p = .015,but this knowledge wasn’t maintained. Subjects improved and maintained their stroke self-efficacy from pretest to long-term posttest and 31% of the teachers achieved their health objective. Another 58.6% stated they made some progress in achieving their stroke reduction objective. Conclusions and Practice Implications: Pilot results reveal some positive stroke outcomes involving middle school teachers. Additional refinements in the FAST program and educational strategies will occur to further enhance information retention and achievement of personal health outcomes prior to testing with a larger sample.

Abstract WP236: The Urban-Rural Divide: Risk Factor Prevalence in Ischemic Stroke Patients Across Two Decades

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Dinesh V Jillella ◽  
Sara Crawford ◽  
Anne S Tang ◽  
Rocio Lopez ◽  
Ken Uchino
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Regression Models ◽  
Stroke Risk ◽  
Stroke Patients ◽  
Stroke Risk Factor ◽  
Risk Factor Prevalence ◽  
Urban Rural ◽  
Artery Disease

Introduction: Regional disparities exist in stroke incidence and stroke related mortality in the United States. We aimed to elucidate the stroke risk factor prevalence trends based on urban versus rural location. Methods: From the National Inpatient Sample database the comorbid stroke risk factors were collected among hospitalized ischemic stroke patients during 2000-2016. Crude and age-and sex-standardized prevalence estimates were calculated for each risk factor during the time periods 2000-2008 and 2009-2016. We compared risk factor prevalence over the defined time periods using regression models, and differences in risk factor trends based on patient location categorized as urban (metropolitan with population of ≥ 1 million) and rural (neither micropolitan or metropolitan) using interaction terms in the regression models. Results: Stroke risk factor prevalence significantly increased from 2000-2008 to 2009-2016. When stratified based on patient location, most risk factors increased in both urban and rural groups. In the crude model, the urban to rural trend difference across 2000-08 and 2009-16 was significant in hypertension (p<0.0001), hyperlipidemia (p=0.0008), diabetes mellitus (p<0.0001), coronary artery disease (p<0.0001), smoking (p<0.0001) and alcohol (p=0.02). With age and sex standardization, the urban to rural trend difference was significant in hypertension (p<0.0001), hyperlipidemia (p=0.0007), coronary artery disease (p=0.01) and smoking (p<0.0001). Conclusion: The prevalence of vascular risk factors among ischemic stroke patients has increased over the last two decades. There exists an urban-rural divide, with rural patients showing larger increases in prevalence of several risk factors compared to urban patients.

Abstract NS6: Family History of Stroke: Invisibility of a Key Stroke Risk Factor among High Risk African Americans

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Dawn M Aycock ◽  
Kenya D Kirkendoll ◽  
Kisha C Coleman ◽  
Karen C Albright ◽  
Anne W Alexandrov
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Perceived Control ◽  
Stroke Risk ◽  
Perceived Threat ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
History Of ◽  
Physiologic Data

Background & Purpose: Young to middle aged African Americans (AA) are at greater risk for a first-ever stroke, severe neurologic disability, and stroke-related mortality, than Caucasians of similar age; however, it remains unclear what role a family history of stroke (FHS) plays in promoting adoption of healthier lifestyles in this cohort. The purpose of this study was to explore differences between rural Stroke Belt AA with a FHS (e.g. parent/grandparent/sibling) on modifiable stroke risk factors, knowledge, perceived threat and perceived control of stroke, and exercise behaviors to AA without a FHS. Methods: A cross-sectional study was conducted recruiting AA aged 19-54 from the Black Belt region of Alabama via a mobile health clinic. Participants’ perceptions, knowledge, exercise history/intent, physiologic data, and health history were recorded. Results: Participants (N=66) averaged 43.3+9.4 years, were 71% female, with at least 12 years of school (89%), and unemployed (62%). Common risk factors were insufficient exercise (76%), obesity (59%), hypertension (53%; blood pressure M=145+17.6/88.3+12.9), and cigarette smoking (38%). Participants with a FHS (n=33) did not differ on average number of risk factors compared to those without a FHS (FHS 2.8+1.4 vs. 2.2+1.5; t(64)= 1.73, p=.089), nor did they differ on physiologic data. However, participants with a FHS were more likely to report a history of hypertension (67%) compared to those without a FHS (33%; χ2 =4.93, p <.05). There were no significant differences between groups for knowledge of stroke risk factors, perceived threat and perceived control of stroke, or recent exercise performance, although participants with a FHS (3.4+1.2) had significantly lower future intentions to exercise compared to those without a FHS (3.9+0.8); t(64)=2.45, p<.05). Conclusions: Although FHS is a significant non-modifiable risk factor for stroke and was common in this young to middle-aged AA cohort, FHS did not drive perceived stroke risk, risk factor control, or current/future intentions to exercise. Identification of interventions designed to personalize FHS as a key stroke risk factor, while promoting lifestyle change and self-management, may play an important role in future primary stroke prevention.

Abstract TP203: Reducing Stroke Burden in Uganda

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mark Kaddumukasa ◽  
Jane Nakibuuka ◽  
James Kayima ◽  
Elly Katabira ◽  
Carol Blixen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Growth Patterns ◽  
Warning Signs ◽  
Clear Understanding ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Study Participants ◽  
Stroke Knowledge

Background: Stroke is a neurological condition with rapidly increasing burden in many low- and middle-income countries. Africa is particularly hard-hit due to rapid population growth, patterns of industrialization, adoption of harmful western diets, and increased prevalence of risk factors such as hypertension and obesity. Reducing stroke risk factors and teaching people to respond to stroke warning signs can prevent stroke and reduce burden. However, being able to address gaps in knowledge and improving both preventative and early-response care requires a clear understanding of practical and potentially modifiable topics. Methods: A cross sectional survey was conducted in urban Mukono district in central Uganda. Through a systematic sampling method, data were gathered from 440 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception, using a pretested structured questionnaire. Results: Of the 440 study participants enrolled for this study nearly 52% correctly reported that stroke involves the brain, while 57% reported that stroke is preventable. Majority of the participants 75.7% reported stress as a contributing factor. Only 45.7% of the study participants reported hypertension as a risk factor. Only two (0.5%) study participants identified cigarette smoking as a stroke risk factor. Of the eighty six study participants with hypertension only 39.5% knew hypertension as a risk factor and only 10.7% knew three or more stroke risk factors. Conclusion: Stroke knowledge is poor in urban Uganda. Individuals with hypertension had poor knowledge regarding stroke in spite their high risk for stroke. Stress and hypertension are the leading perceived risk factors in our settings. While stress is highly reported as a stroke risk factor in this study hypertension is likely a more amenable and practical intervention target.

Non-valvular atrial fibrillation patients with none or one additional risk factor of the CHA2DS2-VASc score

2015 ◽  
Vol 114 (10) ◽  
pp. 826-834 ◽  
Author(s):  
Flemming Skjøth ◽  
Peter Nielsen ◽  
Torben Bjerregaard Larsen ◽  
Gregory Lip
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Additional Risk Factor ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Long Run ◽  
One Year ◽  
Net Clinical Benefit

SummaryOral anticoagulation (OAC) to prevent stroke has to be balanced against the potential harm of serious bleeding, especially intracranial haemorrhage (ICH). We determined the net clinical benefit (NCB) balancing effectiveness and safety of no antithrombotic therapy, aspirin and warfarin in AF patients with none or one stroke risk factor. Using Danish registries, we determined NCB using various definitions intrinsic to our cohort (Danish weights at 1 and 5 year follow-up), with risk weights which were derived from the hazard ratio (HR) of death following an event, relative to HR of death after ischaemic stroke. When aspirin was compared to no treatment, NCB was neutral or negative for both risk strata. For warfarin vs no treatment, NCB using Danish weights was neutral where no risk factors were present and using five years follow-up. For one stroke risk factor, NCB was positive for warfarin vs no treatment, for one year and five year follow-up. For warfarin vs aspirin use in patients with no risk factors, NCB was positive with one year follow-up, but neutral with five year follow-up. With one risk factor, NCB was generally positive for warfarin vs aspirin. In conclusion, we show a positive overall advantage (i.e. positive NCB) of effective stroke prevention with OAC, compared to no therapy or aspirin with one additional stroke risk factor, using Danish weights. ‘Low risk’ AF patients with no additional stroke risk factors (i.e. CHA2DS2-VASc 0 in males, 1 in females) do not derive any advantage (neutral or negative NCB) with aspirin, nor with warfarin therapy in the long run.Note: The review process for this manuscript was fully handled by Christian Weber, Editor in Chief.

scholarly journals Trends of risk profile among middle-aged adults hospitalized for acute ischemic stroke in United States 2006–2017

2020 ◽  
pp. 174749302097937
Author(s):  
Xin Tong ◽  
Quanhe Yang ◽  
Mary G George ◽  
Cathleen Gillespie ◽  
Robert K Merritt
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Risk ◽  
Stroke Patients ◽  
Stroke Risk Factors ◽  
Percent Change ◽  
Lipid Disorders ◽  
Major Stroke

Background Recent studies reported increasing trends in hospitalization of stroke patients aged 35–64 years. Aim To examine changes in risk factor profiles among patients aged 35–64 years hospitalized with acute ischemic stroke between 2006 and 2017 in the United States. Methods We used data from the National Inpatient Sample of the Healthcare Cost and Utilization Project from 2006 through 2017. Principal ICD-9-CM/ICD-10-CM codes were used to identify acute ischemic stroke hospitalizations, and secondary codes were used to identify the presence of four major stroke risk factors: hypertension, diabetes, lipid disorders, and tobacco use. We used the relative percent change to assess the changes in the prevalence of risk profile between 2006–2007 and 2016–2017 and linear regression models to obtain the p values for the overall trends across six time periods. Results Approximately 1.5 million acute ischemic stroke hospitalizations occurred during 2006–2017. The prevalence of having all four risk factors increased from 4.1% in 2006–2007 to 9.1% in 2016–2017 (relative percent change 122.0%, p < 0.001 for trend), prevalence of any three risk factors increased from 24.5% to 33.8% (relative percent change 38.0%, p < 0.001). Prevalence of only two risk factors decreased from 36.1% to 32.7% (p < 0.001), only one risk factor decreased from 25.2% to 18.1% (p < 0.001), and absence of risk factors decreased from 10.1% to 6.2% (p < 0.001). The most prevalent triad of risk factors was hypertension, diabetes, and lipid disorders (14.3% in 2006–2007 and 19.8% in 2016–2017), and the most common dyad risk factors was hypertension and lipid disorders (12.6% in 2006–2007 and 11.9% in 2016–2017). Conclusions The prevalence of hospitalized acute ischemic stroke patients aged 35–64 years with all four or any three of four major stroke risk factors increased by 122% and 38%, while those with only one risk factor or no risk factor has declined by 28% and 39%, respectively, from 2006 to 2017. Younger adults are increasingly at higher risk for stroke from preventable and treatable risk factors. This growing public health problem will require clinicians, healthcare systems, and public health efforts to implement more effective prevention strategies among this population.

scholarly journals The Left Atrial Septal Pouch: A New Stroke Risk Factor?

2021 ◽  
Author(s):  
Ruchi Kapoor ◽  
Lara Wadi ◽  
Brian Becerra ◽  
Michael Eskander ◽  
Ali Razmara ◽  
...  
Keyword(s):  
Risk Factor ◽  
Left Atrial ◽  
Stroke Risk ◽  
Cryptogenic Stroke ◽  
Incomplete Fusion ◽  
Stroke Patients ◽  
Stroke Risk Factor ◽  
Stroke Treatment ◽  
Therapeutic Implications ◽  
Stroke Group

AbstractThe left atrial septal pouch (LASP) occurs due to incomplete fusion of septa primum and secundum at the inter-atrial septum, creating an open flap that may serve as a thromboembolic source. Prior studies have demonstrated increased prevalence of LASP in cryptogenic strokes. The aim of the current study was to validate the above findings in a separate, larger group of stroke and non-stroke patients. We examined transesophageal echocardiograms (TEEs) performed between July 2011 and December 2018. LASP prevalence was determined in TEEs referred for ischemic stroke or transient ischemic attack (“stroke”) and compared with LASP prevalence in patients undergoing TEEs for other reasons (“non-stroke”). Stroke subtyping was performed using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. There were 306 TEEs from 144 non-stroke and 162 stroke patients. Mean age and sex distribution were 56 ± 1 (mean ± SE) and 65% male in the non-stroke group and 58 ± 1 and 54% male in the stroke group. The overall prevalence of LASP was 31%. The prevalence of LASP was 28% (41/144) in non-stroke patients, 25% (24/95) in non-cryptogenic stroke patients, and 43% (29/67) in cryptogenic stroke patients. LASP prevalence was significantly higher in the cryptogenic subgroup compared with the non-cryptogenic subgroup (p = 0.02). These findings demonstrate a significant association of LASP with risk of cryptogenic stroke, suggesting that LASP may serve as a thromboembolic nidus. Additional studies are needed to determine the generalizability of these findings, and their therapeutic implications, supporting LASP as a stroke risk factor.

scholarly journals An Examination of Stroke-Related Knowledge in Male Stroke Survivors Living in the South Carolina Stroke Belt

2014 ◽  
Vol 8 (6) ◽  
pp. 532-537 ◽  
Author(s):  
Charles Ellis
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Racial Differences ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Stroke Survivors ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Stroke Knowledge

Racial differences have been observed in stroke-related knowledge and knowledge of specific stroke risk factors and stroke prevention practices. Using data from 134 male stroke survivors, racial differences in overall knowledge, risk factor knowledge, and stroke prevention practices were examined using the Stroke Knowledge Test. Knowledge that diabetes doubles ones risk of stroke was present in 48% of the participants, while knowledge of aspirin in the prevention of stroke by stopping blood clot formation was reported in 83% of the participants. Findings indicate participants were knowledgeable that obesity increased risk of stroke (71%) and high blood pressure was the most important stroke risk factor (70%). Participants indicated knowledge that diet, exercise, and controlling blood pressure and cholesterol reduces risk of stroke (86%). In regression models, there were no significant race differences in overall stroke knowledge or the odds of knowledge of information related to stroke risk factors and stroke prevention practices after adjusting for age, education, and marital status. Although stroke-related knowledge did not differ by race, stroke survivors exhibited gaps in stroke knowledge particularly of knowledge of common risk factors. These factors should be considered in approaches to improve stroke-related knowledge in all stroke survivors.

Public health campaigns and their effect on stroke knowledge in a high-risk urban population: A five-year study

Vascular ◽  
2017 ◽  
Vol 25 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Maged M Metias ◽  
Naomi Eisenberg ◽  
Michael D Clemente ◽  
Elizabeth M Wooster ◽  
Andrew D Dueck ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Stroke Risk ◽  
High Risk Population ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Awareness Campaigns ◽  
Stroke Symptom ◽  
Stroke Knowledge

Background The level of knowledge of stroke risk factors and stroke symptoms within a population may determine their ability to recognize and ultimately react to a stroke. Independent agencies have addressed this through extensive awareness campaigns. The aim of this study was to determine the change in baseline knowledge of stroke risk factors, symptoms, and source of stroke knowledge in a high-risk Toronto population between 2010 and 2015. Methods Questionnaires were distributed to adults presenting to cardiovascular clinics at the University of Toronto in Toronto, Canada. In 2010 and 2015, a total of 207 and 818 individuals, respectively, participated in the study. Participants were identified as stroke literate if they identified (1) at least one stroke risk factor and (2) at least one stroke symptom. Results A total of 198 (95.6%) and 791 (96.7%) participants, respectively, completed the questionnaire in 2010 and 2015. The most frequently identified risk factors for stroke in 2010 and 2015 were, respectively, smoking (58.1%) and hypertension (49.0%). The most common stroke symptom identified was trouble speaking (56.6%) in 2010 and weakness, numbness or paralysis (67.1%) in 2015. Approximately equal percentages of respondents were able to identify ≥1 risk factor (80.3% vs. 83.1%, p = 0.34) and ≥1 symptom (90.9% vs. 88.7%, p = 0.38). Overall, the proportion of respondents who were able to correctly list ≥1 stroke risk factors and stroke symptoms was similar in both groups.(76.8% vs. 75.5%, p = 0.70). The most commonly reported stroke information resource was television (61.1% vs. 67.6%, p = 0.09). Conclusion Stroke literacy has remained stable in this selected high-risk population despite large investments in public campaigns over recent years. However, the baseline remains high over the study period. Evaluation of previous campaigns and development of targeted advertisements using more commonly used media sources offer opportunities to enhance education.

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