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Obstructive Sleep Apnea: A New Preventive and Therapeutic Target for Stroke A new kid on the block
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independent of traditional risk factors.
Source: The American Journal of Medicine - February 28, 2015 Category: Journals (General) Authors: Vahid Mohsenin Source Type: research

Obstructive Sleep Apnea: A New Preventive and Therapeutic Target for Stroke
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independently of traditional risk factors.
Source: The American Journal of Medicine - February 28, 2015 Category: Journals (General) Authors: Vahid Mohsenin Tags: Review Source Type: research

Apparent Treatment-Resistant Hypertension among Individuals with History of Stroke or Transient Ischemic Attack
and Purpose. Blood pressure control is a paramount goal in secondary stroke prevention; however, high prevalence of uncontrolled blood pressure and use of multiple antihypertensive medication classes in stroke patients suggest this goal is not being met. We determined the prevalence and factors associated with apparent treatment-resistant hypertension in persons with/without stroke or transient ischemic attack..
Source: The American Journal of Medicine - March 11, 2015 Category: Journals (General) Authors: Virginia J. Howard, Rikki M. Tanner, Aaron Anderson, Marguerite R. Irvin, David A. Calhoun, Daniel T. Lackland, Suzanne Oparil, Paul Muntner Source Type: research

Effects of Anticoagulation on Low-Density Lipoprotein-Cholesterol and Ischemic Stroke in Patients with Nonvalvular Atrial Fibrillation
The study by Omelchenko et al1 concluded that, unlike the general population, low-density lipoprotein-cholesterol (LDL-C) levels were not associated with ischemic stroke risk among patients with atrial fibrillation treated with direct oral anticoagulants (DOACs). To arrive at this conclusion, they retrospectively analyzed data of 21,229 patients with a first-time diagnosis of nonvalvular atrial fibrillation treated with DOACs categorized according to the congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack (TIA), vascular disease, age 65 to 74 years, sex category, ...
Source: The American Journal of Medicine - September 28, 2021 Category: General Medicine Authors: Zeeshan H. Ismail, Zekarias T. Asnake, Joshua K. Salabei Tags: Letter Source Type: research

Does CHA2DS2-VASc Improve Stroke Risk Stratification in Postmenopausal Women with Atrial Fibrillation?
Abstract: Background: Risk stratification of atrial fibrillation patients with a congestive heart failure (C), hypertension (H), age ≥ 75 (A), diabetes (D), stroke or transient ischemic attack (TIA) (S2) (CHADS2) score of
Source: The American Journal of Medicine - October 18, 2013 Category: Journals (General) Authors: JoEllyn M. Abraham, Joseph Larson, Mina K. Chung, Anne B. Curtis, Kamakshi Lakshminarayan, Jonathan D. Newman, Marco Perez, Kathryn Rexrode, Nawar M. Shara, Allen J. Solomon, Marcia L. Stefanick, James C. Torner, Bruce L. Wilkoff, Sylvia Wassertheil-Smoll Tags: Clinical research studies Source Type: research

NSAID Use and Association with Cardiovascular Outcomes in Outpatients with Stable Atherothrombotic Disease
Abstract: Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin have been linked to heart failure, salt retention, adverse ventricular remodeling, and thrombosis. We therefore sought to assess their impact on cardiovascular events in outpatients with stable atherothrombotic disease.Methods: We analyzed 44,095 patients in the REduction of Atherothrombosis for Continued Health (REACH) registry with information on NSAID use and 4-year follow-up. Cox proportional hazard models, including NSAID use as a time-dependent covariate, were constructed and adjusted for key baseline characteristics. End points of...
Source: The American Journal of Medicine - November 25, 2013 Category: Journals (General) Authors: Payal Kohli, Ph. Gabriel Steg, Christopher P. Cannon, Sidney C. Smith, Kim A. Eagle, E. Magnus Ohman, Mark J. Alberts, Elaine Hoffman, Jianping Guo, Tabassome Simon, Emmanuel Sorbets, Shinya Goto, Deepak L. Bhatt, REACH Registry Investigators Tags: Clinical research studies Source Type: research

Vascular Risk Factors, Cardiovascular Disease, and Restless Legs Syndrome in Women
Conclusions: In this large cohort of female health professionals, various vascular risk factors are associated with the prevalence of restless legs syndrome. We could not confirm the results of previous reports indicating an association between prevalent cardiovascular disease and restless legs syndrome.
Source: The American Journal of Medicine - February 15, 2013 Category: Journals (General) Authors: Anke C. Winter, Markus Schürks, Robert J. Glynn, Julie E. Buring, J. Michael Gaziano, Klaus Berger, Tobias Kurth Tags: Clinical research studies Source Type: research

CHA2DS2-VASc Score Is Directly Associated with the Risk of Pulmonary Embolism in Patients with Atrial Fibrillation
Conclusions: CHA2DS2-VASc score is directly associated with the incidence of pulmonary embolism in atrial fibrillation.
Source: The American Journal of Medicine - January 1, 2014 Category: Journals (General) Authors: Walid Saliba, Gad Rennert Tags: Clinical research studies Source Type: research

Starry Eye
A 73-year-old female with a past medical history of stroke, hypertension, end stage renal disease on hemodialysis presents to the emergency department for altered mental status and slurred speech. On physical examination, she had a right pupillary defect in a star-like pattern with initial concern for a blown pupil (see image) raising suspicion for acute stroke. Her initial blood pressure was 230/110 mmHg and neuroimaging were unremarkable for stroke. She was admitted for hypertensive emergency.
Source: The American Journal of Medicine - November 6, 2022 Category: General Medicine Authors: Cameron Kahn, Azeem Rathore, Jeffrey House Tags: Clinical Communication to the Editor Source Type: research

CHADS2 Score, Statin Therapy, and Risks of Atrial Fibrillation
This study aimed to evaluate the efficacy of statin treatment for atrial fibrillation prevention in elderly patients with hypertension, and to determine if comorbidity or CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or transient ischemic attack) score can predict the effectiveness of statin treatment. Methods: Patients aged ≥65 years with hypertension were identified from a National Health Insurance research database (a systemic sampling from 2000 to 2009 with a total of 1,000,000 subjects). Medical records of 27,002 patients were used in this study, in which 2400 (8....
Source: The American Journal of Medicine - January 17, 2013 Category: Journals (General) Authors: Chen-Ying Hung, Ching-Heng Lin, El-Wui Loh, Chih-Tai Ting, Tsu-Juey Wu Tags: Clinical research studies Source Type: research

Peripheral arterial disease in patients with atrial fibrillation: The Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study.
Atrial fibrillation and peripheral arterial disease are two conditions associated with high risk of cardiovascular and cerebrovascular complications and mortality.1 –5 There is evidence that coexistence of both these clinical conditions can result to an additive risk of adverse events.6 Indeed, atherosclerotic vascular disease has been linked with stroke, thromboembolism and death in subjects with atrial fibrillation and has been therefore included as one of the components of risk scores, such as the CHA2DS2-VASc score (Congestive Heart failure, Hypertension Age> 75 years, DM, Stroke, Vascular disease) in order to strati...
Source: The American Journal of Medicine - September 17, 2020 Category: General Medicine Authors: Antonios Vitalis, Alena Shantsila, Marco Proietti, Rajiv K. Vohra, Mark Kay, Brian Olshansky, Gregory Y.H. Lip Source Type: research

Early Invasive Versus Initial Conservative Treatment Strategies in Octogenarians with UA/NSTEMI
Abstract: Background: Previous studies have demonstrated improved outcomes with an early invasive strategy in patients with unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI). However, there are limited data for patients ≥80 years of age in these studies.Methods: We used the 2003-2010 Nationwide Inpatient Sample databases to identify all patients ≥80 years of age (octogenarians) with UA/NSTEMI. Multivariable logistic regression was used to compare in-hospital outcomes in octogenarians with UA/NSTEMI undergoing early invasive (coronary angiography within 48 hours of admission, with or without revasculari...
Source: The American Journal of Medicine - November 27, 2013 Category: Journals (General) Authors: Dhaval Kolte, Sahil Khera, Chandrasekar Palaniswamy, Marjan Mujib, Gregg C. Fonarow, Ali Ahmed, Diwakar Jain, William H. Frishman, Wilbert S. Aronow Tags: Clinical research studies Source Type: research

Prevalence of Hyponatremia and Association with Mortality: Results from NHANES
Abstract: Background: Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is associated with adverse outcomes, but its prevalence and significance in the general US population is unknown. Our aims were to determine the prevalence of hyponatremia and its association with mortality in the population.Methods: We performed a population-based, cross-sectional study of 14,697 adults aged ≥18 years who participated in the nationally representative National Health and Nutrition Examination Survey for 1999-2004. By using measurements of serum sodium corrected for dilutional effect of hyperglycemia...
Source: The American Journal of Medicine - November 27, 2013 Category: Journals (General) Authors: Sumit Mohan, Sue Gu, Amay Parikh, Jai Radhakrishnan Tags: Clinical research studies Source Type: research

A ‘Posterior Circulation Stroke’ that Benefits from Vitamins
A 75-year-old woman was admitted for somnolence and confusion. She had been treated for hypertension and hyperlipidemia. One year before, she had been hospitalized for a mild right ataxic hemiparesis attributed to a lacunar stroke and received aspirin 100 mg/day. For the past 6 months, she regularly complained about gastric discomfort and bloating, which was attributed to the aspirin intake. As a consequence of her gastric problems and her decreasing appetite, her food intake was very limited. During a call, 24 hours before admission, she complained about nausea and vomiting for the past 2 days; she felt dizzy and staggere...
Source: The American Journal of Medicine - December 13, 2013 Category: Journals (General) Authors: Theodoros Karapanayiotides, Athanasia Anastasiou, Nikolaos Barmpas, Nikolaos Grigoriadis, Dimitrios Karacostas Tags: Clinical communications to the editor Source Type: research

Treat or Eat: Food Insecurity, Cost-related Medication Underuse, and Unmet Needs
Conclusions: Approximately 1 in 3 chronically ill NHIS participants are unable to afford food, medications, or both. WIC and public health insurance participation are associated with less food insecurity and cost-related medication underuse.
Source: The American Journal of Medicine - January 21, 2014 Category: Journals (General) Authors: Seth A. Berkowitz, Hilary K. Seligman, Niteesh K. Choudhry Tags: Clinical research studies Source Type: research

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