High Blood Pressure (Hypertension)

High blood pressure is a major risk factor for stroke. Blood pressure by definition is the force of blood pushing against the walls of your arteries. High blood pressure causes the heart to pump harder to move blood through the body. This can weaken blood vessels and damage major organs such as the brain. Left untreated, high blood pressure can lead to stroke.

Atrial Fibrillation (AF)

Atrial fibrillation (AF) is caused when the two upper chambers of the heart (atria) beat rapidly and unpredictably, producing an irregular heartbeat. AF raises stroke risk because it allows blood to pool in the heart. When blood pools, it tends to form clots which can then be carried to the brain, causing a stroke. Long-term untreated AF can also weaken the heart, leading to heart failure.

High Cholesterol

Cholesterol is a fatty substance in the blood that the human body makes on its own, but it also comes from fat in foods. High levels of cholesterol in the bloodstream can clog arteries and cause a stroke or heart attack.

Diabetes

In people with diabetes, the body either doesn’t produce enough insulin or the cells ignore the insulin. Without insulin, the body can’t process sugar, which is the basic fuel for the cells in the body. People with diabetes are up to 4 times more likely to have a stroke than someone who does not have the disease, mainly because many people with diabetes have health problems that are also stroke risk factors. 

Atherosclerosis

Atherosclerosis is the progressive buildup of plaque – fatty deposits and other cells – in artery walls. It can clog arteries and block the flow of blood to the brain or other parts of the body, making a person more at risk for a stroke, TIA or other heart disease.

Lifestyle Risk Factors That Can Be Changed:

Tobacco Use/Smoking

Among other things, smoking damages blood vessel walls, speeds up the clogging of arteries, raises blood pressure and makes the heart work harder. Smoking also doubles the risk of stroke.

Alcohol Use

Alcohol use has been linked to stroke in many studies. For example, drinking large amounts of alcohol may increase risk for stroke.

Obesity

Obesity and excess weight put a strain on the entire circulatory system. Obesity also makes people more likely to have high cholesterol, high blood pressure and diabetes — all of which can increase risk for stroke. Adopting healthy eating habits and increasing physical activity can help reduce stroke risk.

For more information on preventing strokes and decreasing your risk of a stroke, visit the National Stroke Association website.

What is post-stroke rehabilitation?

Rehabilitation helps stroke survivors relearning skills that are lost when part of the brain is damaged. For example, these skills can include coordinating leg movements in order to walk or carrying out the steps involved in any complex activity. Rehabilitation also teaches survivors new ways of performing tasks to circumvent or compensate for any residual disabilities. Individuals may need to learn how to bathe and dress using only one hand, or how to communicate effectively when their ability to use language has been compromised. There is a strong consensus among rehabilitation experts that the most important element in any rehabilitation program is carefully directed, well-focused, repetitive practice—the same kind of practice used by all people when they learn a new skill, such as playing the piano or pitching a baseball.

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Rehabilitative therapy begins in the acute-care hospital after the person’s overall condition has been stabilized, often within 24 to 48 hours after the stroke. The first steps involve promoting independent movement because many individuals are paralyzed or seriously weakened. Patients are prompted to change positions frequently while lying in bed and to engage in passive or active range of motion exercises to strengthen their stroke-impaired limbs. (“Passive” range-of-motion exercises are those in which the therapist actively helps the patient move a limb repeatedly, whereas “active” exercises are performed by the patient with no physical assistance from the therapist.) Depending on many factors—including the extent of the initial injury—patients may progress from sitting up and being moved between the bed and a chair to standing, bearing their own weight, and walking, with or without assistance. Rehabilitation nurses and therapists help patients who are able to perform progressively more complex and demanding tasks, such as bathing, dressing, and using a toilet, and they encourage patients to begin using their stroke-impaired limbs while engaging in those tasks. Beginning to reacquire the ability to carry out these basic activities of daily living represents the first stage in a stroke survivor’s return to independence.

For some stroke survivors, rehabilitation will be an ongoing process to maintain and refine skills and could involve working with specialists for months or years after the stroke.

Where can I get more information? 

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, visit their website here.

After a person has had a stroke, it may be necessary for them to wear a medical ID bracelet to communicate any ongoing conditions or medications that they are taking. It may also be a good idea to use a medical alarm system in the home in case of an emergency.

Learn the warning signs of a stroke. Act FAST and CALL 9-1-1 or press the button on your One Call Alert IMMEDIATELY at any sign of a stroke. Use FAST to remember the warning signs.

Stroke symptoms include:

• SUDDEN numbness or weakness of face, arm or leg – especially on one side of the body.
• SUDDEN confusion, trouble speaking or understanding.
• SUDDEN trouble seeing in one or both eyes.
• SUDDEN trouble walking, dizziness, loss of balance or coordination.
• SUDDEN severe headache with no known cause.

Call 9-1-1  or press the button on your One Call Alert immediately if you have any of these symptoms

Stroke is the fourth leading cause of death in America and the leading cause of adult disability.

Myths and Facts about strokes:

Myth: Stroke is unpreventable
Reality: Stroke is largely preventable

Myth: Stroke cannot be treated
Reality: Stroke requires emergency treatment

Myth: Stroke only strikes the elderly
Reality: Stroke can happen to anyone

Myth: Stroke happens to the heart
Reality: Stroke is a “Brain Attack”

Myth: Stroke recovery only happens for a few months following a stroke
Reality: Stroke recovery continues throughout life

For more information, visit the National Stroke Association website at www.stroke.org.

Gestational diabetes and obesity risks higher in women exposed to tobacco in utero

Smoking is a known health hazard for pregnancies. But being exposed to smoke in utero may follow a baby girl into her own pregnancy when she grows up.

A recent study looked at a group of pregnant women who had mothers who smoked while pregnant with them.

The results of this study showed these pregnant women who had mothers who smoked while pregnant had higher odds of developing gestational diabetes and obesity than women whose mother’s did not smoke while they were pregnant.

Dr. Kristina Mattsson, from the Division of Occupational and Environmental Medicine at Lund University in Sweden, led a study into risks associated with smoking during pregnancy.

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For this study, the researchers used data from the Swedish Medical Birth Register, which began recording the smoking status of pregnant mothers in 1982.

Between 1982 and 2010, the researchers found 80,189 pregnancies with enough information to enter into the study.

Since this was a pregnancy study, the researchers were looking at smoking-related consequences in daughters who grew up and became pregnant as well. Specifically, the researchers were looking at gestational diabetes and obesity in the pregnant daughters of women that had smoked during their pregnancies.

Gestational diabetes happens when a woman who has never had diabetes develops high blood sugar while she is pregnant. With gestational diabetes, the blood sugar levels normalize after giving birth.

The researchers found that mothers who smoked moderately (between one to nine cigarettes per day) during pregnancy had daughters that were 1.62 times more likely to develop gestational diabetes when they became pregnant compared to the daughters of women who did not smoke.

Mothers who had been heavy smokers (more than nine cigarettes per day) during pregnancy had daughters that were 1.52 more likely to develop gestational diabetes compared to the daughters of women who did not smoke.

Women who were moderate smokers during their pregnancies were 1.36 times more likely to have daughters that would become obese.

Women who were heavy smokers during their pregnancies were 1.58 times more likely to have daughters that would become obese.

“Women exposed to smoking during fetal life were at higher risk of developing gestational diabetes and obesity,” the study authors wrote.

This study was published in May in Diabetologia.

Previous research has revealed a link between depression and diabetes. In this study, Wayne J. Katon, MD, of the department of psychiatry at the University of Washington Medical School in Seattle, and colleagues sought to examine the prospective connection between depression and risk for severe hypoglycemic episodes that led to a medical emergency or hospitalization. They conducted a longitudinal 2-year study of 4,117 patients with diabetes (aged at least 18 years), making adjustments for sociodemographic, measurements of diabetes severity, medical comorbidities unrelated to diabetes, prior hypoglycemic episodes, and health risk behaviors (smoking and physical activity).

Patients with depression were more likely to be younger, female, unmarried and to be treated with insulin. They also had more nondiabetes-related medical comorbidities, a higher number of diabetes complications, higher BMI and rates of smoking, and they were less physically active.

According to data, patients with depression vs. those without depression displayed significantly higher risk for a severe hypoglycemic episode (HR=1.42; 95% CI, 1.03-1.96) and a higher amount of hypoglycemic episodes (RR=1.34; 95% CI, 1.03-1.74).

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“In the 5-year pre-baseline period, 8.1% of depressed patients with diabetes vs. 3.1% of non-depressed control patients with diabetes experienced one or more severe hypoglycemic episodes,” the researchers wrote. “Over the 5-year follow-up period, 6.9% of patients reported at least one severe hypoglycemic episode. A total of 10.7% of depressed patients with diabetes had one or more severe hypoglycemic episodes, compared with 6.4% among non-depressed control patients.”

After adjusting for confounders and clinical variables, researchers wrote that patients with depression had significantly shorter severe hypoglycemic episodes, but significantly more episodes. However, due to the study’s observational nature, researchers wrote there are limits on interpretations of causality. Further research is needed, they added.

The researchers explained that diets that are high in omega-3 fatty acids are linked to better memory and cognitive function in humans. The Mediterranean diet has plenty of fish, chicken and salad dressing – all of which are rich in omega-3 fatty acids.

Mediterranean food is rich in omega-3 fatty acids

The authors pointed out, though, that not such benefits were found among people with diabetes.

Georgios Tsivgoulis, M.D., a neurologist who works at both the UAB and the University of Athens, said:

“Since there are no definitive treatments for most dementing illnesses, modifiable activities, such as diet, that may delay the onset of symptoms of dementia, are very important.”

Dr. Tsivgoulis and team collected data from the Reasons for Geographic and Racial Differences in Stroke study, which is housed at UAB. The study included data on 30,239 people aged 45+ years between January 2003 and October 2007. They were all followed up regularly for health changes.

In what Tsivgoulis claims is the largest study to date on the Mediterranean diet, dietary data from 14,478 Caucasians and African-Americans were examined to determine how closely they followed a Mediterranean diet. Their average age was 64. The participants also underwent tests to measure their memory and cognitive abilities over a period of four years. Seventeen percent of them had diabetes.

The researchers found that among those without diabetes who followed the Mediterranean diet more closely, the risk of developing problems with memory and thinking skills was 19% lower, compared to the rest of the population sample. The difference in declines between Caucasians and African-Americans was not statistically significant.

Unfortunately, as far as cognition and memory was concerned, no benefit was identified among those with diabetes who closely followed a Mediterranean diet.

Tsivgoulis said:

“Diet is an important modifiable activity that could help in preserving cognitive functioning in late life,” said Tsivgoulis. “However, it is only one of several important lifestyle activities that might play a role in late-life mental functioning. Exercise, avoiding obesity, not smoking cigarettes and taking medications for conditions like diabetes and hypertension are also important.”

The study was sponsored by the Department of Health and Human Services and the National Institute of Neurological Disorders and Stroke (part of the National Institutes of Health).

Researchers from the University of Las Palmas de Gran Canaria and the University of Navarra, both in Spain, reported in the European Journal of Clinical Nutrition (June 2012 issue) that the Mediterranean diet is not only good for physical health, but mental health as well.

In February 2012, researchers from the University of Miami Miller School of Medicine reported in Archives of Neurology that a Mediterranean-style diet may be healthier for the brain. They found that a Mediterranean diet appears to reduce damage to small blood vessels in the brain.

Written by Christian Nordqvist of Medical News Today.

I Love having MyIHR for a Detailed Medical History

The day I realized I needed a medical ID bracelet was a day I was out walking with my friends. We’d chosen to walk down a trail from one city park to the next, a span that stretches about 2 miles each way. The morning of the walk I had eaten cream of rice cereal and nothing else. I wasn’t hungry when we left and didn’t think about eating anything else. I also left my water bottle and purse in the car.

The walk down was great. It was clear and there was almost no wind. We chose to sit for a moment at the end of the 2 miles and that’s when I realized I was shaking. I told my friends that I was shaking, and then told them when I started to break out in a sweat (something that shouldn’t have happened due to our pace and the cooler weather).

One of my friends recognized the signs of my blood sugar dropping and convinced me to sit down while she went back for the car. I’m hypoglycemic.

The scary realization hit me that if it wasn’t for them being there I could have passed out and no one would’ve known what to do or who to contact. That night we all sat around talking and the decision was made, I needed a medical ID bracelet.

While the bracelet is not a solution to how much I failed to do that day, it’s a great comfort. Knowing that if I haven’t paid attention to what I need to do, someone will know how to respond and who to contact. The bracelet I have was carefully chosen based on the information I felt pertinent to my own situation and I love having MyIHR for a detailed medical history. It’s one less thing to worry about when I leave my house.

Melissa Bartlett

MyIHR is a product offered by American Medical ID. There is no recurring fee to include MyIHR on your medical ID.

An article by Sridhar Nadamuni on iTech Post reports:

Credit: National Institute of Mental Health

Post-traumatic stress disorder (PTSD) is a prolonged stress response syndrome involving symptoms that develop in the wake of extremely stressful life events of an extraordinarily threatening or catastrophic nature. The symptoms of PTSD include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts, intrusive memories, avoidance and numbing, or emotional arousal.

The experiences from traumatic events can be managed with time and patience, but in some individuals the symptoms can  get worse, and out of control, shaking up their lives.

Researchers now show that PTSD in turn leads to a significant risk of developing type 2 diabetes.

Dr. Karoline Lukaschek from the Institute of Epidemiology II (EPI II) at the Helmholtz Zentrum München (HMGU) and Prof. Johannes Kruse from the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen and Marburg, and their colleagues from the Helmholtz Zentrum München and the University Hospital Gießen and Marburg now provide the first evidence of a signficant association between the two illnesses.

In the study published in the Journal of Psychosomatic Research, the investigators looked into data from a population-based study in which the data were collected by means of a standardized survey of all participants and also a glucose tolerance test. They identified 50 participants with PTSD, and an additional 261 with symptoms of partial PTSD. They also included 498 participants who suffered from full-blown type 2 diabetes and 333 subjects who  displayed signs of a pre-diabetic condition. The analysis showed a significant association between type 2 diabetes and PTSD. However, prediabetes was not associated with psychological stress. The scientists explain that the chronic and permanent stress among PTSD patients leads to changes in the hormonal response, with the result that the body’s metabolism and glucose utilization are adversely affected. More studies are needed to dig into the detailed mechanisms, the temporal and causal relationships.

“Further clarification of the relationships between psychological factors and metabolic disorders will be an important task for diabetes research in the future”, commented Prof. Karl-Heinz Ladwig.

More information on Type 2 Diabetes can be found on the American Diabetes Association website here.

Symptoms of Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes. Millions of Americans have been diagnosed with type 2 diabetes, and many more are unaware they are at high risk. Some groups have a higher risk for developing type 2 diabetes than others. Type 2 diabetes is more common in African Americans, Latinos,Native Americans, and Asian Americans, Native Hawaiians and other Pacific Islanders, as well as the aged population.

In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications.

When glucose builds up in the blood instead of going into cells, it can cause two problems:

• Right away, your cells may be starved for energy.
• Over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart.

The American Diabetes Association recommends every person with diabetes wear a medical ID bracelet or necklace:

“You should have a medical ID with you at all times. Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person’s full medical record, such as the fact that they have diabetes and use insulin. Emergency medical personnel are trained to look for a medical ID.”