Abstract P631: The Relationship of Neighborhood Greenness to Stroke/ Transient Ischemic Attack in 249,405 US Medicare Beneficiaries

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Scott C Brown ◽  
William Aitken ◽  
Joanna Lombard ◽  
Kefeng Wang ◽  
Tatjana Rundek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transient Ischemic Attack ◽  
Hemorrhagic Stroke ◽  
Medicare Beneficiaries ◽  
Lower Odds ◽  
Neighborhood Income ◽  
Ischemic Attack ◽  
Relationship Of ◽  
The Relationship ◽  
Reduced Risk

Introduction: Nature exposures represent a novel environmental protective factor for chronic disease, which is understudied with respect to stroke and transient ischemic attack. The purpose of the present study is to investigate the relationship between objectively measured neighborhood greenness (vegetative presence) and Stroke/Transient Ischemic Attack (Stroke/TIA), in a population-based sample of Medicare beneficiaries. Methods: The sample was comprised of 249,405 U.S. Medicare beneficiaries ages > 65 years with the same location (ZIP+4) in Miami-Dade County, Florida, from 2010-2011. Analyses examined the relationship of greenness, measured by mean block-level Normalized Difference Vegetation Index (NDVI) from satellite imagery, to a diagnosis of Stroke/TIA. Hierarchical regression analyses, in a multi-level framework, assessed the relationship of greenness to Stroke/TIA, adjusting successively for individual age, gender, race/ethnicity, neighborhood income, and biological risk factors (diabetes, hypertension, hyperlipidemia). Secondary analyses then examined the relationship of greenness separately for specific diagnoses of Transient Ischemic Attack (TIA), Ischemic Stroke, and Hemorrhagic Stroke, respectively. Results: Higher greenness was associated with reduced risk for Stroke/TIA, adjusting for individual sociodemographics and neighborhood income: When compared to individuals residing in the lowest tertile of greenness, those individuals residing in the highest tertile of greenness had a 20% lower odds of Stroke/TIA (OR=0.80; 95% CI: 0.74, 0.86, p<0.0001), as well as a 26% lower odds of TIA (OR=0.74; 95% CI: 0.66, 0.82; p<0.0001) and a 16% lower odds of Ischemic Stroke (OR=0.84; 95% CI: 0.75, 0.95; p=0.0050), but did not have a statistically significantly reduced odds of Hemorrhagic Stroke (OR=0.84; 95% CI: 0.61, 1.16; p=0.2990). Associations were attenuated after adjusting for biological risk factors, suggesting that cardiometabolic risk factors may partly mediate greenness’ relationship to stroke and TIA. Conclusions: Neighborhood greenness may be associated with reduced risk of Stroke/TIA. Policies and strategies to increase greenness may be a future means of reducing Stroke/TIA at the population level.

scholarly journals The relationship of soluble neuropilin-1 to severe COVID-19 risk factors in polycystic ovary syndrome

2021 ◽  
Vol 9 ◽  
pp. 100079
Author(s):  
Abu Saleh Md Moin ◽  
Thozhukat Sathyapalan ◽  
Stephen L. Atkin ◽  
Alexandra E. Butler
Keyword(s):  
Risk Factors ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Neuropilin 1 ◽  
Relationship Of ◽  
The Relationship

Clinical Effects of Dual Antiplatelet Therapy or Aspirin Monotherapy after Acute Minor Ischemic Stroke or Transient Ischemic Attack, a Meta-Analysis

2021 ◽  
Vol 27 ◽  
Author(s):  
Francesco Condello ◽  
Gaetano Liccardo ◽  
Giuseppe Ferrante
Keyword(s):  
Ischemic Stroke ◽  
Major Bleeding ◽  
Transient Ischemic Attack ◽  
Hemorrhagic Stroke ◽  
Dual Antiplatelet Therapy ◽  
Meta Analysis ◽  
Stroke Recurrence ◽  
Controlled Trials ◽  
Minor Ischemic Stroke ◽  
Ischemic Attack

Background: Evidence about the use of dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitors in patients with acute minor ischemic stroke or transient ischemic attack (TIA) is emerging. The aim of our study was to provide an updated and comprehensive analysis about the risks and benefits of DAPT versus aspirin monotherapy in this setting. Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov databases, main international conference proceedings were searched for randomized controlled trials comparing DAPT versus aspirin monotherapy in patients with acute ischemic stroke or TIA not eligible for thrombolysis or thrombectomy presenting in the first 24 hours after the acute event. Data were pooled by meta-analysis using a random-effects model. The primary efficacy endpoint was ischemic stroke recurrence, and the primary safety outcome was major bleeding. Secondary endpoints were intracranial hemorrhage, hemorrhagic stroke, and all-cause death. Results: A total of 4 studies enrolling 21,459 patients were included. DAPT with clopidogrel was used in 3 studies, DAPT with ticagrelor in one study. DAPT duration was 21 days in one study, 1 month in one study, and 3 months in the remaining studies. DAPT was associated with a significant reduction in the risk of ischemic stroke recurrence (relative risk [RR], 0.74; 95% confidence interval [CI], 0.67-0.82, P<0.001, number needed to treat 50 [95% CI 40-72], while it was associated with a significantly higher risk of major bleeding (RR, 2.59; 95% CI 1.49-4.53, P=0.001, number needed to harm 330 [95% CI 149-1111]), of intracranial hemorrhage (RR 3.06, 95% CI 1.41-6.66, P=0.005), with a trend towards higher risk of hemorrhagic stroke (RR 1.83, 95% CI 0.83-4.05, P=0.14), and a slight tendency towards higher risk of all-cause death (RR 1.30, 95% CI 0.89-1.89, P=0.16). Conclusions: Among patients with acute minor ischemic stroke or TIA, DAPT, as compared with aspirin monotherapy, might offer better effectiveness in terms of ischemic stroke recurrence at the expense of a higher risk of major bleeding. The trade-off between ischemic benefits and bleeding risks should be assessed in tailoring the therapeutic strategies.

scholarly journals Risk Factors of Stroke in Young and Old Age Group Admitted in a Tertiary Level Hospital, Dhaka - A Comparative Study

2014 ◽  
Vol 27 (2) ◽  
pp. 94-100
Author(s):  
Md. Nurul Amin Miah ◽  
MA Azhar ◽  
Aminur Rahman ◽  
Durba Halder ◽  
Md. Akteruzzaman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Old Age ◽  
Transient Ischemic Attack ◽  
Oral Contraceptive Pill ◽  
Age Group ◽  
Old Patients ◽  
History Of ◽  
Ischemic Attack ◽  
Stroke In Young

Background: Stroke is an important cause of death and disability. Prevalence of stroke in Bangladesh differs with age. The risk factors in young differ in comparison to old age group. In this study risk factors of stroke in young in comparison to old age group were evaluated. Objectives: To compare the risk factors associated with stroke in young adult and to those of old age group. Methodology: This comparative study conducted in the department of Medicine and Neurology, Sir Salimullah Medical College & Mitford Hospital, Dhaka from January 2008 to June 2009. One hundred two stroke patient of above 15 years of age were confirmed by CT scan or MRI of brain those were included in young and old age groups. The risk factors of stroke were defined in terms of hypertension, diabetes mellitus, dyslipidaemia, ischemic heart diseases, valvular heart disease, history of transient ischemic attack or stroke, smoking and oral contraceptive pill. Results: Of total 102 cases 17 were young adults and 85 old patients between 19 to 100 years. Mean age young adult was 39.76 (± 6.379) and old age was 65.06 (± 11.238). 61.7% were male & 38.2% were female and the ratio was 1.6:1. Amongst male 58.8% patients were smoker in each age group and only 2.9% old patients were alcoholic. Only 17.6% had previous history of transient ischemic attack or stroke in each age group. 58.8% of young and 48.2% of old were hypertensive. 7% old patients had history of ischemic heart disease. 5.9% of young and 2.4% of old patients had valvular heart disease but no patient had vasculitis. 16.7% old patients had diabetes mellitus. 4.9% of total patients (young 11.8% and 3.5% old) were oral contraceptive pill user. Out of all patients 24.7% old patients and 5.9% young adult was dyslipidaemic. Among all patients 66.7% patients had the Ischemic stroke and 33.3% patients had the hemorrhagic stroke. 68.2% old patients and 58.8% young patients had Ischemic stroke; 31.8% old patients and 41.2% young patients had hemorrhagic stroke. Conclusion: In young age group smoking, transient ischemic attack or stroke, hypertension, valvular heart disease, oral contraceptive pill and in old age group smoking, transient ischemic attack or stroke, hypertension, Ischemic heart disease, diabetes mellitus and dyslipidaemia were found significant risk factors for development of stroke. So modification of risk factors may reduce the incidence of stroke. Bangladesh Journal of Neuroscience 2011; Vol. 27 (2) : 94-100 DOI: http://dx.doi.org/10.3329/bjn.v27i2.17576

scholarly journals THE RISK OF FALLS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2017 ◽  
Vol 54 (6) ◽  
pp. 705-711 ◽  
Author(s):  
N. V. Toroptsova ◽  
A. Yu. Feklistov
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Risk Of Falls ◽  
Relationship Of ◽  
The Relationship

The paper discusses the materials of investigations dealing with falls as an independent risk factor for fractures in patients with rheumatoid arthritis (RA). It gives data on the incidence and possible risk factors of falls in this category of patients. According to the data obtained, the prevalence of falls in different countries varies from 10 to 50%, which may be related to differences in the methods of collecting information, and the relationship of the investigated factors with the risk of falls in patients with RA is uniquely unproven and calls for further investigations.

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