Cerebrovasular

Cannabis and Arrhythmia Risk, Stroke and Race, Why Weight Loss Drugs Stop Working

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Within 180 days, 42 medical cannabis users and 107 control participants developed arrhythmia, most commonly atrial fibrillation/flutter. Medical cannabis users had a slightly elevated risk for new-onset arrhythmia compared with nonusers (180-day absolute risk, 0.8% vs 0.4%). The 180-day risk ratio with cannabis use was 2.07 (95% CI, 1.34-2.80), and the 1-year risk ratio was 1.36 (95% CI, 1.00-1.73). Adults with cancer or cardiometabolic disease had the highest risk for arrhythmia with cannabis use (180-day absolute risk difference, 1.1% and 0.8%).

Medical Cannabis for Chronic Pain Tied to Arrhythmia Risk – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/medical-cannabis-chronic-pain-tied-arrhythmia-risk

The overall incidence of stroke and ischemic stroke (IS) decreased among both White and Black people over the past two decades, results of an updated analysis of stroke trends in a representative US population showed.

However, the study showed persistent racial disparities, with incident stroke rates 50%-80% higher in Black people than in their White counterparts. Incident stroke also occurred at an earlier age in Black patients than in White patients (mean age, 62 years vs 71 years, respectively).

The findings were published online on January 10, 2024, in Neurology.

New Data on Stroke Incidence Rates by Race – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/new-data-stroke-incidence-rates-race

And my favorite Saturday morning medical update…

But studies also have shown that once people stop taking these drugs — either by choice, because of shortage, or lack of access — they regain most, if not all, the weight they lost. Arguably more frustrating is the fact that those who continue on the drug eventually reach a plateau, at which point, the body seemingly stubbornly refuses to lose more weight. Essentially, it stabilizes at its set point, said Fatima Cody Stanford, MD, MPH, MPA, MBA, an obesity medicine physician at Massachusetts General Hospital and associate professor at Harvard Medical School in Boston.

Every study of weight loss drugs done over the past 40 years or so shows a plateau, Stanford told Medscape Medical News. “If you look at the phentermine/topiramate studies, there’s a plateau. If you look at the bupropion/naltrexone studies, there’s a plateau. Or if we look at bariatric surgery, there’s a plateau. And it’s the same for the newer GLP-1 drugs.”

The reason? “It really depends on where the body gets to,” Stanford said. “The body knows what it needs to do to maintain itself, and the brain knows where it’s supposed to be. And when you lose weight and reach what you feel is a lower set point, the body resists.”When the body goes below its set point, the hunger hormone ghrelin, which is housed in the brain, gets reactivated and gradually starts to reemerge, she explained. GLP-1, which is housed in the distal portion of the small intestine and in the colon, also starts to reemerge over time.

Why Do GLP-1 Drugs Stop Working, and What to Do About It? – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/why-do-glp-1-drugs-stop-working-and-what-do-about-it

That’s it for this Saturday. Time to go to the Y and read a book later.

Combination of biomarkers can identify common cognitive disease — Health Secrets of a SuperAger

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In recent years, subcortical small-vessel disease has become an increasingly common cognitive diagnosis. Researchers at University of Gothenburg have now shown that it is possible to identify patients with the disease by combining two biomarkers that are measured in spinal fluid and blood, increasing the potential for both treatment and development of medication. Photo by […]

Combination of biomarkers can identify common cognitive disease — Health Secrets of a SuperAger

I found a blogger who is older than me.

Hell yeah I’m gonna follow him.

Exercise Alters Brain Chemistry – May Protect Aging Synapses

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When elderly people stay active, their brains have more of a class of proteins that enhances the connections between neurons to maintain healthy cognition.

University of California – San Francisco. “Exercise alters brain chemistry to protect aging synapses: Enhanced nerve transmission seen in older adults who remained active.” ScienceDaily. http://www.sciencedaily.com/releases/2022/01/220107100955.htm (accessed January 8, 2022).

I was about to write a snarky comment but I forgot what it was.

Journal Reference – Kaitlin Casaletto, Alfredo Ramos‐Miguel, Anna VandeBunte, Molly Memel, Aron Buchman, David Bennett, William Honer. Late‐life physical activity relates to brain tissue synaptic integrity markers in older adults. Alzheimer’s & Dementia, 2022; DOI: 10.1002/alz.12530

Transient Ischemic Attack (TIA) – a Primer

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The incidence of TIA in the United States is estimated to be 200,000-500,000 per year, with a prevalence of 5 million individuals, but is likely underreported.2 Stroke is preceded by TIA in 12-30% of patients and is the 5th leading cause of death in the US, contributing significantly to long term disability.2,3 Strokes occur more commonly in men than women, but women experience more severe morbidity.2,3 Stroke prevalence increases with age and occurs more frequently in black and Hispanic populations.3 It should also be noted that 90% of strokes worldwide occur in the setting of potentially modifiable risk factors which presents an incredible opportunity for early intervention, especially following TIA.2

TIA: Emergency Department Evaluation and Disposition — http://www.emdocs.net/tia-emergency-department-evaluation-and-disposition/?utm_source=feedly&utm_medium=rss&utm_campaign=tia-emergency-department-evaluation-and-disposition

MIND Your Diet

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MIND diet is associated with better cognitive functioning independently of brain pathology, suggesting that the MIND diet may contribute to cognitive resilience in older adults.

Dhana, Klodian et al. ‘MIND Diet, Common Brain Pathologies, and Cognition in Community-Dwelling Older Adults’. 1 Jan. 2021 : 683 – 692. — https://content.iospress.com/articles/journal-of-alzheimers-disease/jad210107

So, what is the MIND diet?

The traditional Mediterranean dietary pattern includes mainly whole, minimally processed plant foods including cereal grains, legumes, vegetables, fruit, nuts, and fish with small amounts of meat, milk, and dairy products and a regular modest amount of alcohol.4 The DASH diet emphasizes fruit, vegetables, and low-fat dairy products and includes whole grains, poultry, fish, and nuts, and is reduced in fats, red meat, sweets, and sugar-containing beverages.4 Combining the two diets, the MIND diet emphasizes natural, plant-based foods, specifically promoting an increase in the consumption of berries and green leafy vegetables, with limited intakes of animal-based and high saturated fat foods.

What Are the Components to the MIND Diet? — https://jandonline.org/article/S2212-2672(15)01251-4/fulltext

I became aware of the MIND diet earlier this year. It’s nice to know my dietary pattern has a name.

Untreated Sleep Apnea Boosts Risk of Heart Disease, Stroke | Medpage Today

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Untreated Sleep Apnea Boosts Risk of Heart Disease, Stroke | Medpage Today.

Compared with OSA-negative patients, untreated OSA was associated with an 86% higher mortality risk (adjusted hazard ratio 1.86, 95% CI 1.81 to 1.91), and treated OSA was associated with a 35% higher mortality risk (aHR 1.35, 95% CI 1.21 to 1.51), wrote Miklos Z. Molnar, MD, PhD, of the University of Tennessee Health Science Center in Memphis, and colleagues, in the journal Thorax.

Untreated OSA also was associated with a 3.5 times higher risk of incident coronary heart disease (aHR 3.54, 95% CI 3.40 to 3.69), and a 3.5 times higher risk of incident strokes (aHR 3.48, 95% CI 3.28 to 3.64), while treated OSA was associated with a threefold higher risk of incident CHD (aHR 3.06, 95% CI 2.62 to 3.56) and 3.5-fold higher risk of incident strokes (aHR 3.50, 95% CI 2.92 to 4.19). The risk of incident kidney disease also was significantly higher in untreated (aHR 2.27, 95% CI 2.19 to 2.36) and treated OSA (aHR 2.79, 95% CI 2.48 to 3.13).