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Source: BMJ Open
Condition: Cholesterol

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Total 35 results found since Jan 2013.

Lipid management in ischaemic stroke or transient ischaemic attack in China: result from China National Stroke Registry III
Conclusions The LDL-C goal achievement rate has increased mildly in the stroke and TIA population in mainland China. Lowered baseline LDL-C level was significantly associated with a decreased short- and long-term risk of ischemic stroke among stroke and TIA patients. LDL-C<1.4mmol/L might be a safe standard for this population.
Source: BMJ Open - March 8, 2023 Category: General Medicine Authors: Xu, Y.-Y., Chen, W.-Q., Wang, M.-X., Pan, Y.-S., Li, Z.-X., Liu, L.-P., Zhao, X.-Q., Wang, Y.-L., Li, H., Wang, Y.-J., Meng, X., on behalf of the CNSR-III Investigators, Wang, Li, Wu, Zhang, He, Gong, Ouyang, Huang, Yu, Wang, Zhang, Wu, Wang, Yu, Zhang, A Tags: Open access, Medical management Source Type: research

Development and internal validation of a multivariable prediction model for 6-year risk of stroke: a cohort study in middle-aged and elderly Chinese population
Conclusion Our nomogram could be convenient, easy to use and effective prognoses for predicting 6-year risk of stroke in middle-aged and elderly Chinese population.
Source: BMJ Open - July 7, 2021 Category: General Medicine Authors: Yu, Q., Wu, Y., Jin, Q., Chen, Y., Lin, Q., Liu, X. Tags: Open access, Epidemiology Source Type: research

Stroke survivors', caregivers' and GPs' attitudes towards a polypill for the secondary prevention of stroke: a qualitative interview study
Conclusions Participants acknowledged potential advantages in a polypill approach for secondary prevention of stroke; however, significant concerns remain. Further research on the efficacy of a polypill is needed to reassure practitioners whose concerns around inflexibility and treatment suitability are likely to influence the decision to prescribe a polypill for secondary prevention of stroke. Acceptability among survivors, caregivers and GPs is likely to determine the uptake and subsequent use of a polypill in the future.
Source: BMJ Open - May 12, 2016 Category: Journals (General) Authors: Jamison, J., Graffy, J., Mullis, R., Mant, J., Sutton, S. Tags: Open access, Cardiovascular medicine, Qualitative research Source Type: research

Statin and dual antiplatelet therapy for the prevention of early neurological deterioration and recurrent stroke in branch atheromatous disease: a protocol for a prospective single-arm study using a historical control for comparison
Introduction Branch atheromatous disease (BAD) contributes to small-vessel occlusion in cases of occlusion or stenosis of large calibre penetrating arteries, and it is associated with a higher possibility of early neurological deterioration (END) and recurrent stroke in acute ischaemic stroke. As the pathology of BAD is due to atherosclerosis, we postulate that early intensive medical treatment with dual antiplatelet therapy (DAPT) and high-intensity statins may prevent END and recurrent stroke in acute small subcortical infarction caused by BAD. Methods and analysis In this prospective, single-centre, open-label, non-ran...
Source: BMJ Open - November 26, 2021 Category: General Medicine Authors: Huang, Y.-C., Lee, J.-D., Weng, H.-H., Lin, L.-C., Tsai, Y.-H., Yang, J.-T. Tags: Open access, Neurology Source Type: research

Retrospective case review of missed opportunities for primary prevention of stroke and TIA in primary care: protocol paper
This study will investigate: (1) the proportion of strokes/TIAs with prior missed opportunities for prevention in primary care; (2) the influence of patient characteristics on missed prevention opportunities and (3) how the proportion of missed prevention opportunities has changed over time. Methods and analysis A retrospective case review will identify first-ever stroke and patients with TIA between 2000 and 2013 using anonymised electronic medical records extracted from the health improvement network (THIN) database. Four categories of missed opportunities for stroke/TIA prevention will be sought: untreated high blood p...
Source: BMJ Open - November 11, 2014 Category: Journals (General) Authors: Moran, G. M., Calvert, M., Feltham, M. G., Marshall, T. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Global health Protocol Source Type: research

Structured follow-up pathway to support people after transient ischaemic attack and minor stroke (SUPPORT TIA): protocol for a feasibility study and process evaluation
Introduction People who experience transient ischaemic attack (TIA) and minor stroke have limited follow-up despite rapid specialist review in hospital. This means they often have unmet needs and feel abandoned following discharge. Care needs after TIA/minor stroke include information provision (diagnosis and stroke risk), stroke prevention (medication and lifestyle change) and holistic care (residual problems and return to work or usual activities). This protocol describes a feasibility study and process evaluation of an intervention to support people after TIA/minor stroke. The study aims to assess the feasibility and ac...
Source: BMJ Open - June 16, 2022 Category: General Medicine Authors: Turner, G. M., Jones, R., Collis, P., Patel, S., Jowett, S., Tearne, S., Foy, R., Atkins, L., Mant, J., Calvert, M. Tags: Open access, Cardiovascular medicine Source Type: research

Identifying factors explaining practice variation in secondary stroke prevention in primary care: a cohort study based on all patients with ischaemic stroke in the Stockholm region
Conclusions A high practice variation for dispensation of all secondary preventive drugs was observed. Patient and PCC level factors indicating good continuity of care and high level of general practitioner education were associated with higher use of statins. Findings are of importance to policymakers as well as individual providers of care, and more research and actions are needed to minimise inequality in healthcare.
Source: BMJ Open - November 21, 2022 Category: General Medicine Authors: Wolf, M., Hasselström, J. K., Carlsson, A., Euler, M. v., Hasselström, J. Tags: Open access, Neurology Source Type: research

154: a pharmacoeconomic evaluation to make decision: is the use of simvastatin 10 mg as an otc medication cost-effective for the primary prevention of stroke amongst women in iran?
Conclusion: In Iran no threshold has been determined but the results were compared with the threshold that WHO recommended (GDP per capita for Iran is $5442.9 for 2014 by World Bank). Considering this threshold, the evaluated intervention could be considered cost-effective.
Source: BMJ Open - February 7, 2017 Category: Journals (General) Authors: Amirsadri, M., Dorri, N. Tags: Open access Oral Source Type: research

Potential effects on cardiometabolic risk factors and body composition by short message service (SMS)-guided training after recent minor stroke or transient ischaemic attack: post hoc analyses of the STROKEWALK randomised controlled trial
Conclusions No clear effect of 3 months daily mobile phone delivered training instructions was detected on body composition, cardiovascular biochemical risk factors or self-perceived health. Further research is needed to evaluate secondary prevention efforts in larger populations after recent stroke. Trial registration number NCT02902367.
Source: BMJ Open - October 18, 2021 Category: General Medicine Authors: Vahlberg, B. M., Lundström, E., Eriksson, S., Holmback, U., Cederholm, T. Tags: Open access, Rehabilitation medicine Source Type: research

PCSK9 inhibition in patients with acute stroke and symptomatic intracranial atherosclerosis: protocol for a prospective, randomised, open-label, blinded end-point trial with vessel-wall MR imaging
Introduction Dual antiplatelet therapy and high-intensity statins are the mainstay treatment in patients with acute stage, symptomatic intracranial atherosclerotic stenosis (ICAS). Alirocumab is a monoclonal antibody that can inhibit proprotein convertase subtilisin–kexin type 9 and effectively lower low-density lipoprotein cholesterol levels with less side effects than statins. We hypothesise that alirocumab treatment in addition to statin therapy could stabilise intracranial plaque and reduce arterial stenosis. Methods and analysis In this prospective, randomised, open-label, blinded end-point study, we will use h...
Source: BMJ Open - April 29, 2022 Category: General Medicine Authors: Huang, Y.-C., Chang, C.-H., Tsai, Y.-H., Weng, H.-H., Lin, L.-C., Lee, J.-D. Tags: Open access, Neurology Source Type: research

Statin use and risk of haemorrhagic stroke in a community-based cohort of postmenopausal women: an observational study from the Women's Health Initiative
Conclusions This retrospective analysis did not show an association between statin use and HS risk among older women. HS risk was higher among women taking statins with antiplatelet agents. These findings warrant further investigation, given potential implications for clinical decision-making.
Source: BMJ Open - February 25, 2015 Category: Journals (General) Authors: Salmoirago-Blotcher, E., Hovey, K. M., Andrews, C. A., Robinson, J. G., Johnson, K. C., Wassertheil-Smoller, S., Crawford, S., Qi, L., Martin, L. W., Ockene, J., Manson, J. E., Nabel, E., Rossouw, J., Ludlam, S., McGowan, J., Ford, L., Geller, N., Prentic Tags: Open access, Cardiovascular medicine, Epidemiology Research Source Type: research

Evaluating quality and its determinants in lipid control for secondary prevention of heart disease and stroke in primary care: a study in an inner London Borough
Conclusions In this study, the key factor that explained poor lipid control in people with CVD was having no current prescription record of a statin. Women were more likely to have poorly controlled cholesterol (independent of comorbid risk factors and after adjusting for age, ethnicity, deprivation index and practice-level variation). Women with CVD should be offered statin prescription and may require higher statin dosage for improved control.
Source: BMJ Open - December 9, 2015 Category: Journals (General) Authors: Dodhia, H., Kun, L., Logan Ellis, H., Crompton, J., Wierzbicki, A. S., Williams, H., Hodgkinson, A., Balazs, J. Tags: Open access, Cardiovascular medicine, General practice / Family practice, Health services research Source Type: research

Cohort profile of the UK Biobank: diagnosis and characteristics of cerebrovascular disease
We described these participants and their medication usage. Participants We identified participants who either self-reported or were identified from a nurse-led interview, having suffered a stroke or a TIA and compared them against participants without stroke ort TIA. We assessed their risk factor burden (sex, age, deprivation, waist to hip ratio (WHR), hypertension, smoking, alcohol intake, diabetes, physical exercise and oral contraception use (oral contraceptive pill, OCP)) and medication usage. Findings to date We studied 502 650 people (54.41% women), 6669 (1.23%) participants self-reported a stroke. The nurse-...
Source: BMJ Open - March 21, 2016 Category: Journals (General) Authors: Hewitt, J., Walters, M., Padmanabhan, S., Dawson, J. Tags: Open access, Cardiovascular medicine, Epidemiology, Geriatric medicine, Neurology Cohort profile Source Type: research

High-intensity statin therapy in patients with chronic kidney disease: a systematic review and meta-analysis
Conclusions High-intensity statin therapy could effectively reduce the risk of stroke in patients with CKD. However, its effects on all-cause mortality, myocardial infarction, heart failure and renal protection remain unclear. Moreover, it is hard to draw conclusions on the safety assessment of intensive statin treatment in this particular population. More studies are needed to credibly evaluate the effects of high-intensity statin therapy in patients with CKD.
Source: BMJ Open - May 15, 2015 Category: Journals (General) Authors: Yan, Y.-L., Qiu, B., Wang, J., Deng, S.-B., Wu, L., Jing, X.-D., Du, J.-L., Liu, Y.-J., She, Q. Tags: Open access, Cardiovascular medicine, Pharmacology and therapeutics Research Source Type: research

Benefit-risk assessment of HMG-CoA reductase inhibitors (statins): a discrete choice experiment
Conclusions The results of benefit–risk assessment from every perspective were somewhat consistent. This study demonstrated the feasibility of applying a discrete choice experiment in the benefit–risk assessment of drugs and encouraged the engagement of multiple stakeholders in the decision-making process.
Source: BMJ Open - February 25, 2016 Category: Journals (General) Authors: Wanishayakorn, T., Sornlertlumvanich, K., Ngorsuraches, S. Tags: Open access, Cardiovascular medicine, Health policy Research Source Type: research