JAMA Cardiovascular Corner

Cardiovascular Corner Low Lipids, Metformin, and Plant-Based Diets

Substituting red meat with high-quality plant protein sources was associated with more favorable changes in cardiovascular risk factors relative to dietary replacements combined in a recent meta-analysis of randomized clinical trials (RCTs) published in Circulation.

 

Stroke Numbers Up Worldwide

In 2010, there were 16.9 million people who had a first stroke, 33 million stroke survivors, and 5.9 million people who died from a stroke — increases of 68%, 84%, and 26% respectively since 1990, according to Valery Feigin, MD, of the Auckland University of Technology in New Zealand, and colleagues.

Stroke mortality rates fell significantly in both groups of countries: by 37% in high-income countries and by 20% in low- and middle-income countries.

via Stroke Numbers Up Worldwide.

Afib Linked to Silent Stroke

MRI indicated silent cerebral ischemia lesions in 89% patients with paroxysmal Afib and 92% with persistent Afib compared with 46% of controls, which wasn’t significantly different between the two types of Afib but was for both versus controls (P<0.01).

The number of these lesions averaged 41 in persistent Afib, 33 in paroxysmal Afib, and 12 in controls, which was significantly different for all three groups.

The high prevalence of these lesions in the control group compared with what has been reported in the general population may have reflected the moderate to high cardiovascular risk among these patients referred for cardiovascular prevention or treatment, the researchers suggested.

The lesions can have either ischemic and embolic origins, but the peculiar “spotted” distribution of “small sharply demarcated lesions, often in cluster, with bilateral distribution, prevalently in the frontal lobe” seen in 50% and 67% of the paroxysmal and persistent Afib patients, respectively, strongly supported an embolic mechanism, they noted.

via Afib Linked to Silent Stroke.

If these findings are replicated in future studies, the question for underwriters is should any Afib risk be Standard mortality?

High Risk for Recurrence or Death After 1st Stroke

After a Stroke, High Risk for a Recurrence – BusinessWeek

For the study, published in the Feb. 16 issue of Neurology, Feng’s team collected data on almost 10,400 people in South Carolina who’d had a stroke.

They found that 25 percent of those who had a stroke died within a year, and eight percent had another stroke within a year of their first stroke.

After one year, the risk for another stroke or death continued to rise, the researchers found, with about 18 percent having had another stroke within four years. In that time, about six percent had a heart attack and 41 percent had died from any cause, including 27 percent whose deaths were attributed to a stroke or heart attack.

CPAP May Reduce Excess Mortality in Stroke Patients with OSA

CPAP May Reduce Excess Mortality in Stroke Patients With Sleep Apnea

A new study confirms that stroke patients who have moderate to severe obstructive sleep apnea (OSA) have a higher mortality risk than those without this condition and suggests that the successful use of continuous positive airway pressure (CPAP) therapy can reduce this excess risk.