Risk factors and psychological impact of syncope in migraine patients

Cephalalgia ◽  
2019 ◽  
Vol 39 (14) ◽  
pp. 1838-1846
Author(s):  
Ai Seon Kuan ◽  
Shih-Pin Chen ◽  
Yen-Feng Wang ◽  
Jong-Ling Fuh ◽  
Chun-Yu Cheng ◽  
...  

Background Migraine is associated with syncope. We investigated risk factors for syncope and burden of syncope in migraine patients. Methods Participants were recruited from a headache clinic. All participants provided information on lifestyle, co-morbidity, syncope, headache and suicide, and completed the MIDAS and HADS questionnaires. Genetic data were available for a subset of participants. Risk of syncope in relation to participant’s characteristics and migraine susceptibility loci, and risks of psychological disorders associated with syncope, were calculated using logistic regression. Results Underweight, regular tea intake, diabetes mellitus, and migraine with aura were associated with increased syncope risks, with adjusted ORs of 1.76 (95% CI 1.03–3.03), 1.84 (95% CI 1.22–2.79), 4.70 (95% CI 1.58–13.95), and 1.78 (95% CI 1.03–3.10), respectively. Preliminary results showed that rs11172113 in LRP1 was associated with syncope risks. Comorbid syncope in migraine patients was associated with increased risks of depression (OR 1.95, 95% CI 1.18–3.22) and suicide attempt (OR 2.85, 95% CI 1.48–5.48). Conclusion Our study showed the potential roles of vascular risk factors in the association between migraine and syncope. Modifiable risk factors for syncope in patients with migraine include body mass index and tea intake. The debilitating psychological impact of co-morbid syncope in migraine patients warrants clinical attention of treating physicians.

2019 ◽  
Vol 7 (4) ◽  
pp. 516-520 ◽  
Author(s):  
Gabriela Novotni ◽  
Milena Jakimovska ◽  
Dijana Plaseska-Karanfilska ◽  
Nikolina Tanovska ◽  
Igor Kuzmanovski ◽  
...  

BACKGROUND: Alzheimer’s disease (AD), the most common cause of dementia, is evolving to become a threatening epidemy of the 21st century. Only 21% of the predicted number of AD patients in Macedonia have been diagnosed and treated, which means that almost 80% are underdiagnosed or misdiagnosed. Apolipoprotein E gene (APOE) is recognised as the strongest genetic risk factor for sporadic AD. Whether and when Alzheimer’s disease develops, depends on the very complex interaction between genetic and modifiable risk factors. It has been known that vascular factors like hypertension, diabetes mellitus, hypercholesterolemia and obesity increase the risk of developing both AD, vascular dementia and mixed AD and vascular pathology AIM: This study aims to evaluate the influence of APOEε4 allele presence and modifiable vascular risk factors (hypertension, diabetes mellitus and dyslipidemia) as prognostic and risk factors for AD and their influence on the age of onset of AD symptoms among 144 AD patients from Macedonia. MATERIAL AND METHODS: Study group of a total of 144 patients diagnosed with AD was evaluated. APOE genotyping was performed using APOE haplotype-specific sequence specific-primer (SSP)-PCR (Polymerase Chain Reaction) methodology. The non-standardized questionnaire was used to obtain information about demographics, lifestyle and modifiable risk factors that could influence disease onset and phenotype. RESULTS: Statistically significant association was found between the presences of APOEε4 allele in AD group versus controls. The presence of APOEε4 allele increases the risk of developing AD in a 3-fold manner. The average age of disease onset in the ε4 carrier group was 67.2 ± 8.3 and in the ε4 non-carrier group 69.7 ± 9.4. This confirms that the presence of APOEε4 allele shifts towards earlier disease onset, though the difference is not statistically significant. Out of the vascular risk factors, only hypertension was significantly associated with earlier AD onset. Out of total 144 patients, in 22.9% the first symptom onset was before the age of 65, that can be considered as early onset Alzheimer’s Disease (EOAD), which is much higher than 5% for EOAD as most of the studies report. CONCLUSIONS: The average age of disease onset of 68.4 years could be considered earlier than the average age of AD onset worldwide. Out of all the vascular risk factors analysed in this study, only hypertension and dyslipidemia were found to significantly increase the risk for developing AD and only the presence of hypertension influences the age of onset, shifting towards earlier disease onset. Public awareness campaigns should be organised to influence general population knowledge about Alzheimer’s disease, early recognition and the influence of modifiable vascular risk factors.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mayowa Owolabi ◽  
FRED S SARFO ◽  
Onoja Akpa ◽  
Joshua Akinyemi ◽  
Albert Akpalu ◽  
...  

Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascular risk factor acquisition. In sub-Saharan Africa, the effect sizes of vascular risk factors for stroke occurrence by age is unknown. Objective: To quantify the magnitude and direction of the effect sizes of key modifiable risk factors of stroke according to three age groups: <50years(young), 50-65 years(middle age) and >65 years(elderly) in West Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular, lifestyle, stroke severity and outcomes were performed. We used conditional logistic regression to estimate adjusted odds ratios (aOR) of vascular risk factors of stroke. Results: Among 3,553 stroke cases, 813(22.9%) were young, 1441(40.6%) were middle-aged and 1299(36.6%) were elderly. Five modifiable risk factors were consistently associated with stroke occurrence regardless of age namely hypertension, dyslipidemia, diabetes mellitus, regular meat consumption and non-consumption of green vegetables. Among the 5 co-shared risk factors, the effect size, aOR(95%CI) of dyslipidemia, 4.13(2.64-6.46), was highest among the young age group, hypertension, 28.93(15.10-55.44) and non-consumption of vegetables 2.34(1.70-3.23) was highest among the middle-age group while diabetes, aOR of 3.50(2.48-4.95) and meat consumption, 2.40(1.76-3.26) were highest among the elderly age group. Additionally, among the young age group cigarette smoking and cardiac disease were associated with stroke. Furthermore, physical inactivity and salt intake were associated with stroke in the middle-age group while cardiac disease was associated with stroke in the elderly age group. Conclusions: Age has a profound influence on the profile, magnitude and direction of effect sizes of vascular risk factors for stroke occurrence among West Africans. Population-level prevention of stroke must target both co-shared dominant risk factors as well as factors that are unique to specific age bands in Africa.


US Neurology ◽  
2010 ◽  
Vol 05 (02) ◽  
pp. 18 ◽  
Author(s):  
Simon Forstmeier ◽  
Andreas Maercker ◽  
◽  

This article summarises empirical findings on major potentially modifiable risk factors in the development of Alzheimer’s disease (AD), drawing on data from longitudinal epidemiological studies on the incidence of AD or any-cause dementia. Risk factors investigated to date include cognitive ability, motivational ability, emotional health, physical activity, social activity and social network, vascular risk factors and nutrition. The authors find most empirical support for two main clusters of risk factors that also represent potential targets for prevention. First, an active and stimulating lifestyle including cognitive, social, and physical activities reduces the risk of AD. Second, the absence of vascular risk factors such as diabetes, hypertension, hypercholesterol and obesity reduces the risk of AD. More prevention trials are warranted to investigate the preventative effects of an active and stimulating lifestyle on the one hand, and vascular health on the other, in delaying the onset of AD or slowing its progression.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Anne-Katrin Giese ◽  
Markus D Schirmer ◽  
Adrian V Dalca ◽  
Ramesh Sridharan ◽  
Lisa Cloonan ◽  
...  

Introduction: White matter hyperintensity (WMH) is a highly heritable trait and a significant contributor to stroke risk and severity. Vascular risk factors contribute to WMH severity; however, knowledge of the determinants of WMH in acute ischemic stroke (AIS) is still limited. Hypothesis: WMH volume (WMHv) varies across AIS subtypes and is modified by vascular risk factors. Methods: We extracted WMHv from the clinical MRI scans of 2683 AIS subjects from the MRI-Genetics Interface Exploration (MRI-GENIE) study using a novel fully-automated, volumetric analysis pipeline. Demographic data, stroke risk factors and stroke subtyping for the Causative Classification of Stroke (CCS) were performed at each of the 12 international study sites. WMHv was natural log-transformed for linear regression analyses. Results: Median WMHv was 5.7cm 3 (interquartile range (IQR): 2.2-12.8cm 3 ). In univariable analysis, age (63.1 ± 14.7 years, β=0.04, SE=0.002), prior stroke (10.2%, β=0.66, SE=0.08), hypertension (65.4%, β=0.75, SE=0.05), diabetes mellitus (23.1%, β=0.35, SE=0.06), coronary artery disease (17.6%, β=0.04, SE=0.002), and atrial fibrillation (14.6%, β=0.48, SE=0.07) were significant predictors of WMHv (all p<0.0001), as well as smoking status (52.2%, β=0.15, SE=0.05, p=0.005), race (16.5% Non-Caucasian, β=0.25, SE=0.07) and ethnicity (8.2% Hispanic, β=0.30, SE=0.11) (all p<0.01). In multivariable analysis, age (β=0.04, SE=0.002), prior stroke (β=0.56, SE=0.08), hypertension (β=0.33, SE=0.05), smoking status (β=0.16, SE=0.05), race (β=0.42, SE=0.06), and ethnicity (β=0.34, SE=0.09) were independent predictors of WMHv (all p<0.0001), as well as diabetes mellitus (β=0.13, SE=0.06, p=0.02). WMHv differed significantly (p<0.0001, unadjusted) across CCS stroke subtypes: cardioembolic stroke (8.0cm 3 , IQR: 4.2-15.4cm 3 ), large-artery stroke (6.9cm 3 , IQR: 3.1-14.7cm 3 ), small-vessel stroke (5.8cm 3 , IQR: 2.5-13.5cm 3 ), stroke of undetermined (4.7cm 3 , IQR: 1.6-11.0cm 3 ) or other (2.55cm 3 , IQR: 0.9-8.8cm 3 ) causes. Conclusion: In this largest-to-date, multicenter hospital-based cohort of AIS patients with automated WMHv analysis, common vascular risk factors contribute significantly to WMH burden and WMHv varies by CCS subtype.


1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21


Author(s):  
Medha Mathur ◽  
Navgeet Mathur

Background: Hypertension is a vascular disorder associated with high morbidity and mortality. Risk factor prevention plays key role in control of the non-communicable diseases. Current study was conducted to assess prevalence of risk factors related to hypertensive patients.Methods: This cross-sectional study was conducted for the period of six months (January to June 2018). Total 672 hypertensive patients were included in this study and subjected to evaluation of modifiable risk factors like obesity, lack of exercise, smoking, dyslipidemia and pre-existing diabetes mellitus along with non-modifiable risk factors like positive family history and age.Results: On risk factor evaluation of 672 hypertensive patients it was found that 601(89.4%) patients had lack of exercise, 210 (31.2%) patients had dyslipidemia, 190 (28.2%) patients were smokers, 164 (24.4%) patients had diabetes mellitus before emergence of hypertension, 132 (19.6%) patients were obese and 498 (74.1%) patient had age more than 60 years, 94 (13.9%) patients had family history of hypertension.Conclusions: High prevalence of risk factors for this non-communicable disease in Indian community is alarming. Dealing with modifiable risk factors by health education, promotion of exercise, favourable life style, dietary modifications, cessation of smoking, screening programmes for early detection of deranged blood pressure, blood sugar, lipid profile can be effective preventive strategies.


Author(s):  
Nutan Bedi ◽  
Archana Omprakash Gulati ◽  
Gauri V. Devasthali

Background: Diabetes is a disease, which if not controlled, affects every cell of the body from head to toe. No wonder it is often referred to as the “SILENT KILLER”. So through our study, we aim to study the correlation between (haemoglobin A1c) HbA1c levels, duration of diabetes and modifiable risk factors with diabetic retinopathy (DR) in patients of type 2 diabetes mellitus.Methods: This study was conducted in 100 patients (200 eyes) who were diagnosed cases of type 2 diabetes mellitus. A detailed history of the duration of diabetes, alcohol intake and smoking and HbA1c levels was taken. Complete ocular examination was done. BMI was also calculated.Results: 2/3rd of the eyes with grade 3 DR were of>10 years duration while 2/3rd of the eyes with grade 2 DR were of 5-10 years duration. Of the eyes with grade 3 DR, all the patients had HbA1c of more than 8. Significant p value shows strong correlation between DR and obesity. No significant correlation of DR was found with alcohol and smoking.Conclusions: The findings in our study endorse the view that duration and HbA1c are important risk factors for occurrence and severity of DR and therefore a regular follow up and good glycemic control is highly essential for the prevention of occurrence and progression of DR. Strong correlation between BMI and DR suggest that lifestyle changes play a pivotal role.


2014 ◽  
Vol 5 (4) ◽  
pp. 1-5 ◽  
Author(s):  
Pijush Kanti Mandal ◽  
Arpan Kumar Day ◽  
Subhraprakash Pramanik ◽  
Shovan Kumar Das ◽  
Sumit Khotick ◽  
...  

Background: To study the prevalence and associated cardiovascular risk factors of ‘Resistant’ hypertension (RHT) in hypertensive patients of India.Methods: A descriptive cross-sectional observational study was carried out among 300 hypertensive patients attending ‘Hypertension Clinic’ and providing informed written consent from October 2013 to December 2013 at Burdwan Medical College and hospital, Burdwan, West Bengal in India. A pre-tested interviewer-administered questionnaire was used for data collection. Results: The prevalence of Resistant hypertension was 23.33% among all hypertensives. The patients with Resistant hypertension were significantly associated with older age groups (>55 years) (77.1% vs. 38.3%, p value <0.001, OR 5.446, 95% CI 2.935 and 10.104), Obesity (BMI > 27.5 kg/m2) (67.1% vs. 45.7%, p value 0.002, OR 2.433, 95% CI 1.387 and 4.268), Diabetes mellitus (72.9% vs. 45.2%, p value <0.001, OR 3.252, 95% CI 1.808 and 5.851), Prolonged hypertension (>10 years; 74.3% vs. 43.9%, p value <0.001, OR 3.690, 95% CI 2.033 and 6.696) and co-morbidity like Ischemic Heart Disease (60% vs. 44.8%, p value 0.026, OR 1.850, 95% CI 1.073 and 3.187) as risk factors as compared to patients with non-resistant hypertension. Conclusions: Nearly one fourth of the hypertensive persons were suffering from Resistant hypertension, which was significantly associated with the presence of older age, obesity, diabetes mellitus, longer duration of hypertension and co-morbidity like Ischemic Heart Disease as risk factors. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9737 Asian Journal of Medical Sciences 2014 Vol.5(4); 1-5


2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Wong CM ◽  
Faiz D ◽  
Diana Safraa S ◽  
Raja Mohd Azim RH ◽  
Siti Zubaidah AR

Introduction: Non-communicable disease accounted for 73% of premature death in year 2015 Malaysian national survey. The orang asli population may be affected similarly. The prevention of non-communicable diseases should start as early as modifiable risk factors prevention, as proposed by STEPWISE approach of WHO. This study aims to identify the prevalence of hypertension, diabetes mellitus and dyslipidaemia among Jakun orang asli population and examine the association with risk factors. Methods: This is a cross-sectional study analysing 72 case reports of General health screening done in year 2015. The study population was adult Jakun orang asli Tasik Chini using cluster sampling followed by simple random sampling methods. Chi Square test was used for bivariate analysis of relationship each variable has with the diseases, and binary logistic regression was used to analyse association of covariates with each disease. Results: The prevalence was 41.7% for hypertension, 25% for Diabetes mellitus, 6.9% for dyslipidaemia. Education level was significantly related to hypertension, X2 = 11.565 (1), p =0.001; obesity was significantly related to diabetes, X 2 = 8.333 (1), p=0.004. After adjusted for covariates, low education level has 13.379 odds of getting hypertension. Obesity has 7.384 odds of getting diabetes mellitus; female gender has higher odds of getting dyslipidaemia while younger age, physically active and not smoking are protective factors. Conclusion: Higher prevalence of hypertension and diabetes mellitus was found among Tasik Chini orang asli population. Lower sociodemographic characteristics and unhealthy lifestyle factors are associated with the diseases.


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