Reducing your stroke risk…because I care

With all the upcoming excitement about Halloween, you may have overlooked the fact that yesterday was World Stroke Day.

This year, the global campaign to tackle stroke was highlighted with the slogan “Because I care…”.

The phrase showcases the role of caregivers in supporting people who have suffered a stroke and aims to correct misinformation about the disease, such as the misconception that stroke only happens later in life.

Every other second, stroke attacks a person, regardless of age or gender. Of the 15 million people who experience a stroke each year, six million do not survive. Worldwide about 30 million people have had a stroke and most have residual disabilities.

Overall approximately 55 000 more women have strokes than men each year, mainly because stroke occurs more frequently at older ages and women generally live longer than men. Of note, women are twice as likely to die from a stroke than breast cancer each year.

And recent data published in the Lancet, shows a striking 25% worldwide increase in the number of stroke cases in people aged between 20 and 64. This younger age group now accounts for a shocking 31% of strokes.

But, with greater awareness, these figures don’t have to continue their alarming trend.  Stroke can be prevented, treated and managed in the long term. The campaign theme “Because I care” emphasizes these areas.

The slogan was chosen as it can easily be adapted to all cultures and in any setting. It attempts to address prevailing misinformation about the disease, e.g., stroke only happens later in life. The campaign also celebrates the important contributions of caregivers and the role they play as conduits between the stroke community and the general public in correcting misinformation.

Because I care…

• I want you to know the facts about stroke
• I will work to break down the myths surrounding stroke
• I want you to learn how to minimize your risk of stroke
• I want you to have access to the best possible treatment
• I will ensure that you receive quality treatment, care and support
• I will be with you every step of the way towards your full recovery

Research presented at the recent European Society of Cardiology [ESC] Congress  showed that there are plenty of steps young obese women can take to reduce their risk of stroke. In young women without metabolic disorders such as high blood pressure, high cholesterol and high blood sugar  or abnormal glucose metabolism being overweight did not increase the chance of having a stroke compared to normal weight women without metabolic disorders. However, the risk of stroke increased by 3.5 times in women who were overweight and had metabolic disorders.

Study author, Dr Michelle Schmiegelow said: “Obesity puts young women at a major risk of developing high blood pressure, diabetes or high cholesterol, which dramatically increases their likelihood of having a stroke. Young women who are overweight or obese probably have a window of opportunity to lose weight and keep a healthy lifestyle so that they reduce their risk of getting high blood pressure, diabetes and high cholesterol. In this way they can protect themselves from having a stroke or heart attack.”

Awareness of important risk factors, such as atrial fibrillation  and hypertension, is crucial.

Professor Joep Perk, MD, a Swedish Cardiologist and spokesperson for the ESC says: “Women are at the same risk of stroke as men, and the level of risk is completely steered by the underlying risk factor pattern they have. The majority of people who have a stroke are disabled for the rest of their lives and may be paralyzed or lose their ability to speak. The devastating consequences of this disease for patients and their loved ones make prevention even more important.”

He adds: “Prevention for all cardiovascular disease follows the same pattern, be it stroke, heart attack, or peripheral arterial disease. Step one for women is absolutely to stop smoking – that beats everything. The second most important thing is to know your blood pressure to see if you are at risk. And finally, adopt healthy behaviors like eating heart healthy food and keeping the amount of salt you eat under control.”

The global campaign against stroke asks people to commit to six stroke challenges:
•    Know your personal risk factors: high blood pressure, diabetes, and high blood cholesterol
•    Be physically active and exercise regularly
•    Maintain a healthy diet high in fruit and vegetable and low in salt and keep blood pressure low
•    Limit alcohol consumption
•    Avoid cigarette smoke. If you smoke, seek help to stop now
•    Learn to recognize the warning signs of a stroke and how to take action.

Check, check, check, check, check and check!  I’m feeling up to the stroke challenge.  Are you?

10 Brain Damaging Habits

According to the World Health Organization here’s 10 habits that can severely damage your brain:

1.  No Breakfast – Skipping breakfast in order to lose weight or save time is totally wrong and directly affects our brain. Those who don’t take breakfast or take unhealthy breakfast having lower blood sugar level and sometime it may cause overweight.

2. Overreacting – causes hardening of the brain arteries, leading to a decrease in mental power.

3. High Sugar consumption – Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development by reducing the production of Brain Derived Neutrotrophic Factor, without which the brain cannot learn.

4. Smoking – causes brain shrinkage, damages memory, judgment, learning and thinking powers and may even lead to dementia and Alzheimer’s disease.

5. Air Pollution – The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation – Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping – Sleeping with the head covered decreases available air space and forces you to start breathing carbon dioxide instead of oxygen. This leads to a rise in intracranial pressure and results in brain hypoxia which may lead to brain damaging effects.

8. Working your brain during illness – Working hard or studying with sickness may lead to a decrease in effectiveness of the brain. When we are sick the brain is at its weakest and becomes more easily stressed. This stress can also affect memory.

9. Drinking too little water – Water is the main source of energy and is essential for brain function and activity of neurotransmitters. Dehydration can lead to anger, stress, exhaustion, depression and lack of mental clarity.

10. Rarely Talking – Intellectual conversations help to train and promote efficiency of the brain. Conversely, lack of stimulating thoughts may cause brain shrinkage. Reading SRxA’s Word on Health and discussing the content with friends is an excellent way to avoid this!  So grab a glass of water and subscribe today. Consider it free brain fuel!

Teaching your child the ABC’s of Heart Health

Heart disease is not a major cause of death among children and teenagers, but according to the Centers for Disease Control and Prevention it is the largest cause of death among adults in the United States. In fact, someone in America dies every 37 seconds from some form of cardiovascular disease.

Certain factors that play an important role in a person’s chances of developing heart disease. Some of these life-style risk factors can be changed, treated, or modified, and some, such as congenital heart disease cannot.

Zachary Stone M.D, a primary care physician at the University of Alabama, agrees that it’s possible to build a future free from cardiovascular disease by starting heart-healthy habits at a young age. Most of the risk factors that affect children can be controlled early in life.

“The process of atherosclerosis, which is the hardening of the arteries and is known to cause heart attacks, strokes and sudden death, has been shown to begin in early childhood,” says Stone. “It’s important to concentrate on healthy lifestyles in children to prevent adult cardiovascular disease.”

The three main areas to watch are diet, activity levels and smoke exposure.

Diet: Good nutrition can help to decrease cardiovascular disease. It can help prevent hypertension, high cholesterol and obesity. Obesity is a major risk factor for heart disease. 1 out of every 3 American adults is obese and obesity is linked to more than 110,000 deaths in the United States each year. Childhood obesity in the United States is also on the rise. According to the American Academy of Child and Adolescent Psychiatry, between 16% and 33% of children and teenagers are obese. Because obese children are more likely to be obese adults, preventing or treating obesity in childhood may reduce the risk of adult obesity.  A young person’s diet should be low in saturated fats and primarily consist of fruits, vegetables and whole grains.

Activity: One easy way to increase physical activity in children is to limit their sedentary activities.  Parents should limit television and multimedia to 1-2 hours per day and ensure that their kids participate in at least one hour of moderate activity daily.

Smoke exposure:  Exposure to smoke is dangerous to the health of a child for many reasons, including that it can increase the risk of developing heart disease as an adult. According to the CDC, more than 3.6 million middle and high school students smoke cigarettes, and nearly 4,000 kids under age 18 try their first cigarette every day.  More than 90,000 people die each year from heart diseases caused by smoking. Among young people who would otherwise have a very low risk of heart disease, cigarette smoking may cause as many as 75% of the cases of heart disease. And, the longer a person smokes, the higher the risk of heart disease. Parents should talk openly to their kids about both the dangers and bad effects of smoking, such as yellow teeth, bad breath, smelly clothes, shortness of breath and lung damage.  Parents also need to act as a role model for their children, by not smoking or allowing others around them to smoke, thereby reducing their exposure to second-hand smoke.

Keeping kids heart healthy is an investment in their future and yours, and may be the best gift you can ever give.

Sweet Relief for Cough

If like millions of Americans you reach for drops or syrup at the first sign of a cough this post is for you. Until now, most cough experts were unsure if, and how, these popular remedies work.

However, new findings from the Monell Center –  a non-profit institute dedicated to research on the senses of taste and smell – may provide the answer.

It turns out that  both sucrose and menthol, ingredients used as flavorings in many of these preparations, can themselves, reduce coughing.

Cough is a vital protective reflex that clears the respiratory tract of threats from mechanical stimuli like food and chemical stimuli such as airborne toxins and pollutants. As such, cough is necessary to protect the lungs, and keep our airways clear.

“Individuals with a weak cough reflex are at increased risk of pneumonia and of choking. Conversely, many acute and chronic conditions involve frequent coughing, leading to 30 million health care visits annually, with billions spent on over-the-counter medications and billions more lost due to reduced productivity,” said lead author, Paul Wise, PhD, a sensory psychologist at Monell.

However, many aspects of coughing remain poorly understood, including how chemicals act to trigger and modulate cough.

The study, published in Pulmonary Pharmacology and Therapeutics, involved 12 healthy young adults. Each participant  inhaled nebulized capsaicin, the burning ingredient in chili peppers which induces a cough. After each inhalation, the amount of capsaicin was doubled. This procedure continued until the subject coughed three times within 10 seconds. The capsaicin concentration that induced the three coughs was labeled as the individual’s cough threshold.

In some sessions, the subjects held either a very sweet sucrose or plain water in their mouths for three seconds, before spitting the liquid into a sink, and inhaling from the nebulizer.

In other sessions, subjects inhaled three breaths of either menthol-saturated air or clean air before each capsaicin inhalation. The menthol concentration was selected to approximate the cooling intensity of a menthol cigarette.

Both sucrose and menthol increased the amount of capsaicin needed to elicit a cough relative to plain water or clean air, respectively. Sucrose increased cough threshold by about 45%, while menthol increased it by approximately 25%.

“This is the first study to empirically show that sweet taste reduces cough. This also is the first study to show that menthol alone can reduce coughing in response to a cough-eliciting agent,” said co author Paul Breslin, PhD.

The findings support the hypothesis that adding menthol to cigarettes may make it easier to begin smoking by suppressing the cough reflex, thus making the first cigarettes less distressing.

The researchers are planning further studies to explore the chemical elicitation of cough, along with the receptors and genes involved in this system.

In the meantime, it appears that sweet breath mints might be every bit as effective as cough drops… and possibly a whole lot cheaper.

The changing co-morbidities of COPD

It seems that people suffering from chronic obstructive pulmonary disease (COPD) who are on long-term oxygen therapy (LTOT) have more to worry about than breathing difficulties.

According to a new study from Sweden, COPD patients on LTOT face an increased risk of death from cardiovascular disease and other non-respiratory ailments. The findings were published in the online version of the American Journal of Respiratory and Critical Care Medicine.

“In recent decades the demography of patients starting LTOT for COPD has changed markedly,” said principal researcher Magnus P. Ekström.

The mean age of patients starting LTOT increased from approximately 66 to 73 years between 1987 and 2000.  In parallel there has also been a significant increase in the proportion of women receiving LTOT for COPD.

The researchers enrolled 7,628 adult patients who started LTOT for COPD between January 1987 and December 2004. Patients remained in the study until LTOT was suspended or until death. Study participants were followed for a median of 1.7 years.

5,497 patients died during the course of the study. Although the risk of death decreased annually for both respiratory disease (2.7%) and lung cancer (3.4%), it increased for circulatory disease (2.8%) and digestive organ disease (7.8%). The overall risk of death increased by 1.6% per year during the study period.

In total, the risk of death for cardiovascular disease increased by 61.5% between 1987 and 2004, the authors noted.  According to the authors, the shift in mortality is partly attributable to an increase in the age of patients starting LTOT, which in turn may be related to decreases in tobacco use.

“In our view, the mechanism that underlies the increases in both overall mortality and mortality due to non-respiratory causes is that the patients have a progressively higher burden of coexisting diseases and conditions, and become more vulnerable with increasing age,” Dr. Ekström said. “Physicians who treat COPD with LTOT need to be aware of these shifts and to monitor for other conditions that may influence the risk of death in these patients.”

SRxA’s Pulmonology and Health Outcomes Advisors can help pharmaceutical companies develop programs to educate physicians about COPD. To find out more, contact us today.

Smoke Across the Water

While many people in the US are frustrated with healthcare reforms, SRxA’s Word on Health has learned that the grass isn’t always greener elsewhere.

This week, doctors in the UK have been told to stop referring smokers for any routine elective surgery unless their patients quit or complete a government run Stop Smoking course.

The controversial plans, which have already provoked anger among Family Practitioners, have been tabled as part of a draconian package of cost-cutting measures.

Other tactics include extending waiting times for surgery and a halt to all consultant-to-consultant referrals for the rest of the financial year unless clinically urgent.

Family doctors are also being asked to play a greater role in stopping their patients from going to the ER in order to drive down costs.

In a letter sent to all General Practitioners in the South West of England, the National Health Service (NHS) said: ‘There is good evidence to show that stopping smoking prior to surgery reduces length of stay and infection rates, and improves healing time; it is also a time when people are often highly motivated to give up. All patients who smoke and are booked for planned surgery will therefore be required to complete a NHS Stop Smoking course prior to surgery. Going forward, all patients requiring planned surgery should be referred to a NHS Stop Smoking Service before being added to the waiting list. A ‘Non Smoker’ status OR completion of the program is the threshold for surgical referral.’

Opponents of the scheme argue that this will only make waiting lists longer and denies smokers their basic human rights.

Word on Health would love to hear your views on this. Should patients be forced to give up smoking in order to have surgery?  Should smokers pay higher health insurance premiums because they consume higher amounts of healthcare costs?

Have your say now.