scholarly journals Stroke and air pollution. a worldwide public health problem

2020 ◽  
pp. 19-22
Author(s):  
M. Giroud ◽  
◽  
J. Reis ◽  
Keyword(s):  
Public Health ◽  
Air Pollution ◽  
Risk Factor ◽  
Public Health Problem ◽  
Vascular Risk Factor ◽  
Vascular Risk ◽  
Local Data ◽  
Public Health Policies ◽  
History Of ◽  
Ischemic Attack

After myocardial infarction, stroke is now associated with air pollution. From local data and literature, we report the strength of the association between air pollution and stroke. We try to understand the biological mechanisms between exposure to air pollutants and stroke risk. The association between air pollution and stroke is strong, confirmed and real. Air pollution and small particulate matter are the most toxic. Patients with classical neuro-vascular risk factors or a history of stroke or transient ischemic attack are at risk of stroke induced by air pollution. Air pollution is a serious modifiable risk factor for stroke and a silent killer inducing stroke. This new neuro-vascular risk factor is useful for public health policies.

scholarly journals Stroke and air pollution. a worldwide public health problem

2020 ◽  
pp. 19-22
Author(s):  
M. Giroud ◽  
◽  
J. Reis ◽  
Keyword(s):  
Public Health ◽  
Air Pollution ◽  
Risk Factor ◽  
Public Health Problem ◽  
Vascular Risk Factor ◽  
Vascular Risk ◽  
Local Data ◽  
Public Health Policies ◽  
History Of ◽  
Ischemic Attack

After myocardial infarction, stroke is now associated with air pollution. From local data and literature, we report the strength of the association between air pollution and stroke. We try to understand the biological mechanisms between exposure to air pollutants and stroke risk. The association between air pollution and stroke is strong, confirmed and real. Air pollution and small particulate matter are the most toxic. Patients with classical neuro-vascular risk factors or a history of stroke or transient ischemic attack are at risk of stroke induced by air pollution. Air pollution is a serious modifiable risk factor for stroke and a silent killer inducing stroke. This new neuro-vascular risk factor is useful for public health policies.

A review of epidemiological research on stroke and dementia and exposure to air pollution

2018 ◽  
Vol 13 (7) ◽  
pp. 687-695 ◽  
Author(s):  
Yannick Béjot ◽  
Jacques Reis ◽  
Maurice Giroud ◽  
Valery Feigin
Keyword(s):  
Air Pollution ◽  
Risk Factor ◽  
Public Health Problem ◽  
Prior History ◽  
Vulnerable Patients ◽  
Dementia Risk ◽  
History Of ◽  
Narrative Literature ◽  
Short And Long Term ◽  
Narrative Literature Review

Background Outdoor air pollution is now a well-known risk factor for morbidity and mortality, and is increasingly being identified as a major risk factor for stroke. Methods A narrative literature review of the effects of short and long-term exposure to air pollution on stroke and dementia risk and cognitive functioning. Results Ten papers on stroke and 17 on dementia were selected. Air pollution, and in particular small particulate matter, contributes to about one-third of the global stroke burden and about one-fifth of the global burden of dementia. It particularly affects vulnerable patients with other vascular risk factors or a prior history of stroke in low- and medium-income countries. New pathophysiological mechanisms of the cause-effect associations are suggested. Conclusion Air pollution should be considered as a new modifiable cerebrovascular and neurodegenerative risk factor. This massive worldwide public health problem requires environmental health policies able to reduce air pollution and thus the stroke and dementia burden.

Abstract P207: Medication Use for Secondary Stroke Prevention and Vascular RIsk Factor Modification Remains Low Among Americans

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Karen C Albright ◽  
Rikki M Tanner ◽  
Amelia K Boehme ◽  
T. Mark Beasley
Keyword(s):  
Risk Factor ◽  
Stroke Prevention ◽  
Medication Use ◽  
Prescription Medication ◽  
Vascular Risk Factor ◽  
Secondary Stroke Prevention ◽  
Vascular Risk ◽  
Risk Factor Modification ◽  
History Of ◽  
Factor Modification

Background: With a US prevalence of 795,000 strokes per year and stroke recurrence rates up to 20%, the objective of this study was to determine the prevalence of prescription medication use for secondary stroke prevention and vascular risk factor modification among noninstitutionalized US adults and compare medication use in Whites and Blacks. Methods: A cross-sectional study was performed as part of the National Health and Nutrition Examination Survey (NHANES) 2009-2010. Demographic, disease, and prescription medication use were obtained via a standardized interview. Participants were asked if they had ever been told by a health professional that they had hypertension, diabetes, high cholesterol, or a stroke. Additionally, participants were asked if they had taken or used any prescription medicine in the past month as well as the names of each prescription medication. Statistical analyses used NHANES sample weights to provide prevalence estimates for the US population. Results: Among 11,375 participants (21% Black, 47.6% men, age 20-80), medication use for secondary stroke prevention and vascular risk factors remained low (Table 1). Participants who reported taking either an antiplatelet agent or an anticoagulant with a history of stroke remained low (7.9% Whites vs 6.2% Blacks). More Blacks with hypertension reported taking blood pressure lowering agents (38.9 vs 36.1% Whites). Diabetic medication use was lower in Blacks reporting a history of diabetes (24.5 vs 25.7% Whites). Medication use rates were lowest in participants reporting high cholesterol, with more Whites reporting use of a cholesterol lowering medication (19.3 vs 14.6%; p<0.001). Conclusion: Despite the prevalence of stroke and vascular risk factors, only a small proportion of people at risk are on medications for secondary stroke prevention and vascular risk factor modification. Overall, Blacks were taking fewer medications for secondary stroke prevention and vascular risk factor modification with the exception of anti-hypertension medication.

PUBLIC HEALTH PROBLEM IN THE HISTORY OF RUSSIAN SOCIOLOGY

2017 ◽  
Vol 19 (3) ◽  
pp. 155-159
Author(s):  
I.E. Levchenko ◽  
◽  
A.Y. Kuznetsov ◽  
E.G. Korniltseva ◽  
◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
History Of

Epidemiological surveillance and performance assessment: the two roles of health indicators during the COVID-19 pandemic

2021 ◽  
Vol 17 (2) ◽  
pp. 186-203
Author(s):  
Nathan Genicot
Keyword(s):  
Public Health ◽  
Performance Assessment ◽  
Health Indicators ◽  
Health Policies ◽  
Epidemiological Surveillance ◽  
Public Health Policies ◽  
History Of ◽  
And Performance ◽  
The One ◽  
Massive Development

AbstractThe COVID-19 pandemic has given rise to the massive development and use of health indicators. Drawing on the history of international public health and of the management of infectious disease, this paper attempts to show that the normative power acquired by metrics during the pandemic can be understood in light of two rationales: epidemiological surveillance and performance assessment. On the one hand, indicators are established to evaluate and rank countries’ responses to the outbreak; on the other, the evolution of indicators has a direct influence on the content of public health policies. Although quantitative data are an absolute necessity for coping with such disasters, it is critical to bear in mind the inherent partiality and precarity of the information provided by health indicators. Given the growing importance of normative quantitative devices during the pandemic, and assuming that their influence is unlikely to decrease in the future, they call for close scrutiny.

Abstract WMP14: Association of Systolic Blood Pressure, LDL Cholesterol, and Hgb A1c With White Matter Hyperintensity on MRI in the ACCORDION MIND Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Tanya Turan ◽  
Rebecca Gottesman ◽  
Sharon Yeatts ◽  
Shyam Prabhakaran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Regression Models ◽  
Ldl Cholesterol ◽  
Vascular Risk Factor ◽  
White Matter Hyperintensity ◽  
Vascular Risk ◽  
Linear Regression Models ◽  
Risk Factor Profile ◽  
The Mean

Introduction: While retrospective studies have shown that poor control of vascular risk factors is associated with progression of white matter hyperintensity (WMH), it has not been studied prospectively. Hypothesis: We hypothesize that higher systolic blood pressure (SBP) mean, LDL cholesterol, and Hgb A1c will be correlated with WMH progression in diabetics. Methods: This is a secondary analysis of the Memory in Diabetes (MIND) substudy of the Action to Control Cardiovascular Risk in Diabetes Follow-on Study (ACCORDION). The primary outcome was WMH progression, evaluated by fitting linear regression models to the WMH volume on the month 80 MRI and adjusting for the WMH volume on the baseline MRI. The primary predictors were the mean values of SBP, LDL, and A1c from baseline to month 80. We defined a good vascular risk factor profile as mean SBP <120 mm Hg and mean LDL <120 mg/dL. Results: We included 292 patients, with a mean (SD) age of 62.6 (5.3) years and 55.8% male. The mean number of SBP, LDL, and A1c measurements per patient was 17, 5, and 12. We identified 86 (29.4%) patients with good vascular risk factor profile. In the linear regression models, mean SBP and LDL were associated with WMH progression and in a second fully adjusted model they both remained associated with WMH progression (Table). Those with a good vascular risk factor profile had less WMH progression (β Coefficient -0.80, 95% CI -1.42, -0.18, p=0.012). Conclusions: Our data reinforce prior research showing that higher SBP and LDL is associated with progression of WMH in diabetics, likely secondary to chronic microvascular ischemia, and suggest that control of these factors may have protective effects. This study has unique strengths, including prospective serial measurement of the exposures, validated algorithmic measurement methodology for WMH, and rigorous adjudication of study data. Clinical trials are needed to investigate the effect of vascular risk factor reduction on WMH progression.

Abstract 121: Vascular Risk Factor Control in the Year After Ischemic Stroke Versus Myocardial Infarction

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Dawn M Bravata ◽  
Jared Brosch ◽  
Jason Sico ◽  
Fitsum Baye ◽  
Laura Myers ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Standard Deviation ◽  
Vascular Risk Factor ◽  
Vascular Risk ◽  
Hypertension Control ◽  
Stroke Patients ◽  
Risk Factor Control ◽  
Facility Level

Background: The Veterans Health Administration has multiple quality improvement activities directed at improving vascular risk factor control. We sought to examine facility quality of blood pressure (BP) control (<140/90 mm Hg), lipid control (LDL-cholesterol <100 mg/dL) and glycemic control (HbA1c <9%) in the one-year after hospitalization for ischemic stroke or acute myocardial infarction (AMI). Methods: We assembled a retrospective cohort of patients hospitalized with stroke or AMI (fiscal year 2011). Facilities were included if they admitted ≥25 stroke patients and ≥25 AMI patients. A facility-level consolidated measure of vascular risk factor control was calculated for the 3 processes of care (number of passes divided by number of opportunities). Results: A total of 2432 patients had a new stroke and 4873 had a new primary AMI (at 75 facilities). Stroke patients had worse vascular risk factor control than AMI patients (mean facility rate on consolidated measure: stroke, 70% [95%CI 0.68-0.72] vs AMI, 77% [0.75-0.78]). The greatest disparity between stroke and AMI patients was in hypertension control: at 87% of hospitals, fewer stroke patients achieved BP control than AMI patients (mean facility pass rate: stroke, 41% vs AMI, 52%; p<0.0001). Overall there were no statistical differences for stroke versus AMI patients in facility-level hyperlipidemia control (71% vs 73%, p=0.33) and glycemic control (79% versus 82%, p=0.24). AMI patients had more outpatient visits than stroke patients in the year after discharge [AMI: mean 7.9 visits (standard deviation 6.1)]; stroke: mean 6.0 visits (standard deviation 4.5; p<0.0001].); the primary difference in outpatient utilization was additional cardiology visits for AMI patients (2.5 visits with cardiology per AMI patient vs 0.4 visits per stroke patient; p<0.001). Conclusions: These results demonstrated clinically substantial disparities in hypertension control among patients with stroke vs patients with AMI. It may be that cardiologists provided risk factor management to AMI patients that stroke patients did not receive. The etiology of these observed differences merits additional investigation.

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