scholarly journals The Effects ofChunghyul-Dan(A Korean Medicine Herbal Complex) on Cardiovascular and Cerebrovascular Diseases: A Narrative Review

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Woo-Sang Jung ◽  
Seungwon Kwon ◽  
Seung-Yeon Cho ◽  
Seong-Uk Park ◽  
Sang-Kwan Moon ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Ethanol Extract ◽  
Inhibitory Effect ◽  
Cerebrovascular Diseases ◽  
Stroke Recurrence ◽  
Neuroprotective Effects ◽  
Clinical Safety ◽  
Endogenous Catecholamine ◽  
Rhei Rhizoma ◽  
Coa Reductase

Chunghyul-dan(CHD) is a herbal complex containing 80% ethanol extract and is composed ofScutellariae Radix,Coptidis Rhizoma,Phellodendri Cortex,Gardeniae Fructus, andRhei Rhizoma. We have published several experimental and clinical research articles on CHD. It has shown antilipidemic, antihypertensive, antiatherosclerotic, and inhibitory effects on ischemic stroke recurrence with clinical safety in the previous studies. The antilipidemic effect of CHD results from 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase and pancreatic lipase-inhibitory activity. The antihypertensive effect likely results from the inhibitory effect on endogenous catecholamine(s) release and harmonization of all components showing the antihypertensive effects. Furthermore, anti-inflammatory and antioxidant effects on endothelial cells are implicated to dictate the antiatherosclerotic effects of CHD. It also showed neuroprotective effects on cerebrovascular and parkinsonian models. These effects of CHD could be helpful for the prevention of the recurrence of ischemic stroke. Therefore, we suggest that CHD could be a promising medication for treating and preventing cerebrovascular and cardiovascular diseases. However, to validate and better understand these findings, well-designed clinical studies are required.

Heat Shock Protein 70 kDa as a Target for Diagnostics and Therapy of Cardiovascular and Cerebrovascular Diseases

2019 ◽  
Vol 25 (6) ◽  
pp. 710-714 ◽  
Author(s):  
Ekaterina V. Konstantinova ◽  
Natalia S. Chipigina ◽  
Marina H. Shurdumova ◽  
E.I. Kovalenko ◽  
Alexander M. Sapozhnikov
Keyword(s):  
Myocardial Infarction ◽  
Ischemic Stroke ◽  
Heat Shock ◽  
Cerebrovascular Diseases ◽  
Peripheral Blood Lymphocytes ◽  
Neuroprotective Effects ◽  
Adverse Conditions ◽  
Shock Proteins ◽  
Diagnostics And Therapy ◽  
Main Factor

Acute focal ischemia is a main factor of pathogenesis of a number of widespread cardiovascular and cerebrovascular diseases, in particular, myocardial infarction and ischemic stroke. It is known that under the conditions of ischemia expression of intracellular heat shock proteins (HSPs), especially HSP70, grows greatly irrespective of the cell type. This stress-induced cell response is connected with cytoprotective properties of HSP70. The protective functions of HSP70 contribute to the cell survival under adverse conditions and inhibit development of programmed cell death. It was shown, that the level of HSP70 increases in cardiomyocytes and brain cells in response to ischemia, that was connected with cardioprotective and neuroprotective effects. Besides, in recent years, clinical studies of HSP70 have demonstrated elevated level of HSP70 in peripheral blood lymphocytes in groups of patients with ischemic stroke and myocardial infarction. This review indicates that HSP70 can serve as a target for developing new approaches to diagnostics and therapy of cardiovascular and cerebrovascular diseases.

scholarly journals Beyond Lipid-Lowering: Effects of Statins on Cardiovascular and Cerebrovascular Diseases and Cancer

2021 ◽  
Author(s):  
Yoichi Morofuji ◽  
Shinsuke Nakagawa ◽  
Kenta Ujifuku ◽  
Takashi Fujimoto ◽  
Kaishi Otsuka ◽  
...  
Keyword(s):  
Cell Types ◽  
Pharmacological Action ◽  
Cerebrovascular Diseases ◽  
Lipid Lowering ◽  
Neuroprotective Effects ◽  
First Line Therapy ◽  
Reductase Inhibitors ◽  
Growth Inhibitory ◽  
Hmg Coa Reductase Inhibitors ◽  
Coa Reductase

The 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, also known as statins, are administered as first-line therapy for hypercholesterolemia, both as primary and secondary prevention. Besides the lipid-lowering effect, statins have been suggested to inhibit the development of cardiovascular disease through anti-inflammatory, antioxidant, vascular endothelial function-improving, plaque-stabilizing, and platelet aggregation-inhibiting effects. The preventive effect of statins on atherothrombotic stroke has been well established, but statins can influence other cerebrovascular diseases. This suggests that statins have many neuroprotective effects in addition to lowering cholesterol. Furthermore, research suggests that statins cause pro-apoptotic, growth-inhibitory, and pro-differentiation effects in various malignancies. Preclinical and clinical evidence suggests that statins inhibit tumor growth and induce apoptosis in specific cancer cell types. The pleiotropic effects of statins on cardiovascular and cerebrovascular diseases have been well established; however, the effects of statins on cancer patients have not been fully elucidated and are still controversial. This review discusses the recent evidence on the effects of statins on cardiovascular and cerebrovascular diseases and cancer. Additionally, this study describes the pharmacological action of statins, focusing on the aspect of ‘beyond lipid-lowering.’

scholarly journals Danggui-Shaoyao-San (DSS) Ameliorates Cerebral Ischemia-Reperfusion Injury via Activating SIRT1 Signaling and Inhibiting NADPH Oxidases

2021 ◽  
Vol 12 ◽  
Author(s):  
Yunxia Luo ◽  
Hansen Chen ◽  
Bun Tsoi ◽  
Qi Wang ◽  
Jiangang Shen
Keyword(s):  
Ischemic Stroke ◽  
Reperfusion Injury ◽  
Aqueous Extract ◽  
Nitrosative Stress ◽  
Ischemia Reperfusion Injury ◽  
Apoptotic Cell ◽  
Ischemia Reperfusion ◽  
Ethanol Extract ◽  
Dependent Manner ◽  
Neuroprotective Effects

Danggui-Shayao-San (DSS) is a famous Traditional Chinese Medicine formula that used for treating pain disorders and maintaining neurological health. Recent studies indicate that DSS has neuroprotective effects against ischemic brain damage but its underlining mechanisms remain unclear. Herein, we investigated the neuroprotective mechanisms of DSS for treating ischemic stroke. Adult male Sprague-Dawley (S.D.) rats were subjected to 2 h of middle cerebral artery occlusion (MCAO) plus 22 h of reperfusion. Both ethanol extract and aqueous extract of DSS (12 g/kg) were orally administrated into the rats at 30 min prior to MCAO ischemic onset. We found that 1) ethanol extract of DSS, instead of aqueous extract, reduced infarct sizes and improved neurological deficit scores in the post-ischemic stroke rats; 2) Ethanol extract of DSS down-regulated the expression of the cleaved-caspase 3 and Bax, up-regulated bcl-2 and attenuated apoptotic cell death in the ischemic brains; 3) Ethanol extract of DSS decreased the production of superoxide and peroxynitrite; 4) Ethanol extract of DSS significantly down-regulated the expression of p67phox but has no effect on p47phox and iNOS statistically. 5) Ethanol extract of DSS significantly up-regulated the expression of SIRT1 in the cortex and striatum of the post-ischemic brains; 6) Co-treatment of EX527, a SIRT1 inhibitor, abolished the DSS’s neuroprotective effects. Taken together, DSS could attenuate oxidative/nitrosative stress and inhibit neuronal apoptosis against cerebral ischemic-reperfusion injury via SIRT1-dependent manner.

Assessment of quality of life in patients with the effects of transient ischemic stroke

2016 ◽  
pp. 37-39
Author(s):  
A. Babirad
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Large Scale ◽  
Cerebrovascular Diseases ◽  
Control Measures ◽  
Sociological Research ◽  
Cerebrovascular Events ◽  
Sf 36 ◽  
Angioplasty And Stenting

Cerebrovascular diseases are a problem of the world today, and according to the forecast, the problem of the near future arises. The main risk factors for the development of ischemic disorders of the cerebral circulation include oblique and aging, arterial hypertension, smoking, diabetes mellitus and heart disease. An effective strategy for the prevention of cerebrovascular events is based on the implementation of large-scale risk control measures, including the use of antiagregant and anticoagulant therapy, invasive interventions such as atheromectomy, angioplasty and stenting. In this connection, the efforts of neurologists, cardiologists, angiosurgery, endocrinologists and other specialists are the basis for achieving an acceptable clinical outcome. A review of the SF-36 method for assessing the quality of life in patients with the effects of transient ischemic stroke is presented. The assessment of quality of life is recognized in world medical practice and research, an indicator that is also used to assess the quality of the health system and in general sociological research.

High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

2019 ◽  
Vol 16 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Jiann-Der Lee ◽  
Ya-Han Hu ◽  
Meng Lee ◽  
Yen-Chu Huang ◽  
Ya-Wen Kuo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Prior History ◽  
Multivariate Logistic Regression ◽  
Cart Analysis ◽  
Younger Age ◽  
History Of ◽  
One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

scholarly journals Sex disparity in long-term stroke recurrence and mortality in a rural population in the United States

2020 ◽  
Vol 13 ◽  
pp. 175628642097189
Author(s):  
Clare Lambert ◽  
Durgesh Chaudhary ◽  
Oluwaseyi Olulana ◽  
Shima Shahjouei ◽  
Venkatesh Avula ◽  
...  
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Rural Population ◽  
The United States ◽  
Competing Risk ◽  
Stroke Recurrence ◽  
Composite Outcome ◽  
Stroke Patients ◽  
Central Pennsylvania ◽  
All Cause Mortality

Background: Several studies suggest women may be disproportionately affected by poorer stroke outcomes than men. This study aims to investigate whether women have a higher risk of all-cause mortality and recurrence after an ischemic stroke than men in a rural population in central Pennsylvania, United States. Methods: We analyzed consecutive ischemic stroke patients captured in the Geisinger NeuroScience Ischemic Stroke research database from 2004 to 2019. Kaplan–Meier (KM) estimator curves stratified by gender and age were used to plot survival probabilities and Cox Proportional Hazards Ratios were used to analyze outcomes of all-cause mortality and the composite outcome of ischemic stroke recurrence or death. Fine–Gray Competing Risk models were used for the outcome of recurrent ischemic stroke, with death as the competing risk. Two models were generated; Model 1 was adjusted by data-driven associated health factors, and Model 2 was adjusted by traditional vascular risk factors. Results: Among 8900 adult ischemic stroke patients [median age of 71.6 (interquartile range: 61.1–81.2) years and 48% women], women had a higher crude all-cause mortality. The KM curves demonstrated a 63.3% survival in women compared with a 65.7% survival in men ( p = 0.003) at 5 years; however, the survival difference was not present after controlling for covariates, including age, atrial fibrillation or flutter, myocardial infarction, diabetes mellitus, dyslipidemia, heart failure, chronic lung diseases, rheumatic disease, chronic kidney disease, neoplasm, peripheral vascular disease, past ischemic stroke, past hemorrhagic stroke, and depression. There was no adjusted or unadjusted sex difference in terms of recurrent ischemic stroke or composite outcome. Conclusion: Sex was not an independent risk factor for all-cause mortality and ischemic stroke recurrence in the rural population in central Pennsylvania.

scholarly journals Impacts of treatments on recurrence and 28-year survival of ischemic stroke patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ting-Ann Wang ◽  
Tzy-Haw Wu ◽  
Shin-Liang Pan ◽  
Hsiu-Hsi Chen ◽  
Sherry Yueh-Hsia Chiu
Keyword(s):  
Ischemic Stroke ◽  
Cerebrovascular Disease ◽  
Cox Regression ◽  
Controlled Trial ◽  
Stroke Recurrence ◽  
Long Term Effects ◽  
Stroke Patients ◽  
Double Blind ◽  
Term Survival

AbstractAspirin and nicametate are well-established therapies for preventing recurrence and mortality from stroke in patients diagnosed as ischemic stroke. However, their respective effects on the recurrence, making allowance for the duration of recurrence and death without the occurrence of recurrence, and long-term survival have not been well elucidated. We aimed to evaluate long-term effect of two kinds of treatment on cerebrovascular death among ischemic stroke patients with or without the recurrence of stroke. Data used in this study were derived from the cohort based on a multicenter randomized double-blind controlled trial during 1992 to 1995 with the enrollment of a total of 466 patients with first-time non-cardioembolic ischemic stroke who were randomly allocated to receive aspirin (n = 222) or nicametate (n = 244). The trial cohort was followed up over time to ascertain the date of recurrence within trial period and death until Sep of 2019. The time-dependent Cox regression model was used to estimate the long-term effects of two treatments on death from cerebrovascular disease with and without recurrence. A total of 49 patients experienced stroke recurrence and 89 cerebrovascular deaths was confirmed. Patients treated with nicametate were more likely, but non statistically significantly, to have recurrence (aHR: 1.73, 95% CI 0.96–3.13) as compared with those treated by aspirin. Nicametate reduced the risk of cerebrovascular death about 37% (aHR: 0.63, 95% CI 0.41–0.97) compared with aspirin. The aspirin group had a lower recurrence rate than the nicametate group even with recurrence after 1–2 years of follow-up of first stroke but the latter had significantly reduced death from cerebrovascular disease for nicametate group, which requires more research to verify.

scholarly journals Association between physical exercise and stroke recurrence among first-ever ischemic stroke survivors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lisha Hou ◽  
Mier Li ◽  
Ju Wang ◽  
Yawen Li ◽  
Qianwen Zheng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Exercise Duration ◽  
Stroke Recurrence ◽  
Stroke Survivors ◽  
Face To Face ◽  
Baseline Information ◽  
Exercise Type ◽  
The Relationship

AbstractThe relationship between exercise and stroke recurrence is controversial. This study was designed to test whether an association exists between exercise and ischemic stroke recurrence in first-ever ischemic stroke survivors. Data were collected from January 2010 to June 2016. Baseline information was obtained during face-to-face interviews, and follow-up phone interviews were conducted every 3 months. Exercise type, frequency, intensity, and duration were recorded. Discrete-time survival analysis was used to determine the relationship between exercise and stroke recurrence. 760 first-ever ischemic stroke survivors who were able to exercise were enrolled. After adjusting for covariates, patients who exercised 3.5–7 h per week and more than 7 h per week had a lower relapse risk than patients who did not exercise (3.5–7: OR 0.415; > 7: OR 0.356). Moreover, if the fluctuation of exercise duration was over 4 h, the patients had a higher risk of stroke recurrence than those with variability of less than 2 h (OR 2.153, P = 0.013). Stroke survivors who engage in long-term regular mild exercise (more than 5 sessions per week and lasting on average 40 min per session) have a lower recurrence rate. Irregular exercise increases the risk of stroke recurrence.

2014 Chinese guidelines for secondary prevention of ischemic stroke and transient ischemic attack

2017 ◽  
Vol 12 (3) ◽  
pp. 302-320 ◽  
Author(s):  
Yongjun Wang ◽  
Ming Liu ◽  
Chuanqiang Pu
Keyword(s):  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Transient Ischemic Attack ◽  
Recurrent Stroke ◽  
Stroke Recurrence ◽  
Evidence Based ◽  
Cerebrovascular Disorder ◽  
Level Of Evidence ◽  
Vascular Stenosis ◽  
Ischemic Attack

Ischemic stroke and transient ischemic attack (TIA) are the most common cerebrovascular disorder and leading cause of death in China. The Effective secondary prevention is the vital strategy for reducing stroke recurrence. The aim of this guideline is to provide the most updated evidence-based recommendation to clinical physicians from the prior version. Control of risk factors, intervention for vascular stenosis/occlusion, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke are all recommended, and the prevention of recurrent stroke in a variety of uncommon causes and subtype provided as well. We modified the level of evidence and recommendation according to part of results from domestic RCT in order to facility the clinical practice.

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