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Condition: Hypertension

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Blood pressure management in stroke: Five new things
Hypertension is a major modifiable risk factor for stroke, with an estimated 51% of stroke deaths being attributable to high systolic blood pressure globally.1,2 The management of hypertension in stroke is determined by timing, the type of stroke, use of thrombolysis, concurrent medical conditions, and pharmacologic variables. We highlight the details of elevated blood pressure management in the hyperacute/acute, subacute, and chronic stages of ischemic stroke and intracerebral hemorrhage.
Source: Nature Clinical Practice - October 13, 2014 Category: Neurology Authors: Bowry, R., Navalkele, D. D., Gonzales, N. R. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Infarction, Intracerebral hemorrhage Five New Things Source Type: research

Systolic and Diastolic Blood Pressure Changes in Relation With Myocardial Infarction and Stroke in Patients With Coronary Artery Disease Clinical Trials
In conclusion, in patients with coronary artery disease and initially free from congestive heart failure, a BP reduction from baseline over the examined BP range had little effect on the risk of MI and predicted a lower risk of stroke. An increase in systolic BP from baseline increased the risk of stroke and MI. The relationships of BP with risk were much steeper for stroke than for MI. A treatment-induced BP reduction over the explored range seems to be safe in patients with coronary artery disease. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00153101.
Source: Hypertension - December 10, 2014 Category: Cardiology Authors: Verdecchia, P., Reboldi, G., Angeli, F., Trimarco, B., Mancia, G., Pogue, J., Gao, P., Sleight, P., Teo, K., Yusuf, S. Tags: Secondary prevention, Clinical Studies, Other Stroke Treatment - Medical Clinical Trials Source Type: research

Low blood pressure during the acute period of ischemic stroke is associated with decreased survival
Conclusion: Among patients hospitalized for their first-ever ischemic stroke, the risk of all-cause death is significantly increased in those with admission MBP below 100 mmHg and discharge SBP below 120 mmHg, even after adjustments for other confounders.
Source: Journal of Hypertension - January 6, 2015 Category: Cardiology Tags: ORIGINAL PAPERS: Stroke Source Type: research

Rates of Ischemic Stroke During Warfarin Treatment for Atrial Fibrillation Brief Reports
Conclusions— In a large cohort of older patients with atrial fibrillation, we observed the highest rate of ischemic stroke in the first 30 days after warfarin initiation. Although causation cannot be established given the observational nature of this study, our findings highlight the need for future research in this population.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Tung, J. M., Mamdani, M. M., Juurlink, D. N., Paterson, J. M., Kapral, M. K., Gomes, T. Tags: Cardiovascular Pharmacology, Anticoagulants, Epidemiology Brief Reports Source Type: research

Effect of Cigarette Smoking on Outcomes of Acute Ischemic Stroke Treated with Intravenous Thrombolysis: Is There Any Paradox in The Brain? (P3.071)
Conclusion: There is no smoker's paradox in ischemic stroke.Disclosure: Dr. Hussein has nothing to disclose. Dr. Niemann has nothing to disclose. Dr. Stuck has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Hussein, H., Niemann, N., Stuck, L., Qureshi, A. Tags: Cerebrovascular Disease and Interventional Neurology: Ischemic Stroke Outcome Source Type: research

Racial differences in the Risk factors, Severity, Outcomes and Treatment in Acute Ischemic Stroke (P7.141)
Conclusion: Despite great disparity in both groups the outcomes were similar.Disclosure: Dr. Chauhan has nothing to disclose. Dr. Ali has nothing to disclose. Dr. Bianchi has nothing to disclose. Dr. Hinduja has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Chauhan, M. A., Ali, S., Bianchi, N., Hinduja, A. Tags: Cerebrovascular Disease and Interventional Neurology: Race, Ethnicity, and Stroke Source Type: research

Insular Cortex Lesions, Cardiac Troponin, and Detection of Previously Unknown Atrial Fibrillation in Acute Ischemic Stroke: Insights From the Troponin Elevation in Acute Ischemic Stroke Study Clinical Sciences
Conclusions— Insular cortex involvement, higher admission high-sensitivity cardiac troponin T, older age, hypertension, and longer monitoring are associated with new detection of AF during in-hospital ECG monitoring. Patients with higher high-sensitivity cardiac troponin T or insular cortex involvement may be candidates for prolonged ECG monitoring.
Source: Stroke - April 27, 2015 Category: Neurology Authors: Scheitz, J. F., Erdur, H., Haeusler, K. G., Audebert, H. J., Roser, M., Laufs, U., Endres, M., Nolte, C. H. Tags: Acute Cerebral Infarction Clinical Sciences Source Type: research

Abstract 18: Determinants of Adequate Blood Pressure Control in Stroke Patients Post-Discharge Session Title: Concurrent Session IIC: Oral Abstracts - Stroke
Conclusions: Contrary to our hypothesis, once daily dosed BP medications did not improve the effectiveness of BP control at follow-up. Elevated SBP at the time of hospital discharge was associated with poor blood pressure control. Those patients receiving outpatient home health and therapy visits after hospital discharge had better blood pressure control. Further studies need to be done to assess medication adherence to determine whether the poor control was related to choice of medication or patient medication-taking behavior.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Bishop, L., Arnan, M., Petryna, E., Bushnell, C. Tags: Session Title: Concurrent Session IIC: Oral Abstracts - Stroke Source Type: research

Clinical and Economic Implications of Apixaban Versus Aspirin in the Low-Risk Nonvalvular Atrial Fibrillation Patients Clinical Sciences
Conclusions— Anticoagulant treatment with apixaban versus aspirin in low-risk patients, as identified using CHADS2 or CHA2DS2–VASc, is projected to increase life expectancy and provide clinical benefits that are cost effective.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Lip, G. Y. H., Lanitis, T., Mardekian, J., Kongnakorn, T., Phatak, H., Dorian, P. Tags: Primary prevention, Cerebrovascular disease/stroke, Anticoagulants, Antiplatelets Clinical Sciences Source Type: research

Predictors of Good Outcome After Stent-Retriever Thrombectomy in Acute Basilar Artery Occlusion Brief Reports
Conclusions— This study suggested that initial infarction severity and posterior circulation Acute Stroke Prognosis Early CT Score on a pretreatment DWI are independent predictors of clinical outcome after stent-retriever thrombectomy in patients with acute basilar artery occlusion.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Yoon, W., Kim, S. K., Heo, T. W., Baek, B. H., Lee, Y. Y., Kang, H. K. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Computerized tomography and Magnetic Resonance Imaging Brief Reports Source Type: research

A call for new attitudes on infection, vaccination, and childhood stroke
Population-based estimates of the incidence of childhood stroke range from 2.6 to 13 cases per 100,000 children per year. Unlike in adults, conventional stroke risk factors such as arterial hypertension, diabetes, and cigarette smoking make little contribution to the etiology of stroke in children. Developmental, genetic, and environmental factors are major contributors to ischemic stroke in children.
Source: Neurology - October 26, 2015 Category: Neurology Authors: Biller, J., Heyer, G. L. Tags: Childhood stroke, All Infections, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke, Case control studies EDITORIALS Source Type: research

Long-Term Stroke Risk Due to Partial White-Coat or Masked Hypertension Based on Home and Ambulatory Blood Pressure Measurements: The Ohasama Study Epidemiology/Population
In conclusion, impacts of partial WCHT as well as partial masked hypertension for long-term stroke risk were comparable to those of complete masked hypertension or sustained hypertension. We need both home and 24-h ambulatory blood pressure measurements to evaluate stroke risk accurately.
Source: Hypertension - December 9, 2015 Category: Cardiology Authors: Satoh, M., Asayama, K., Kikuya, M., Inoue, R., Metoki, H., Hosaka, M., Tsubota-Utsugi, M., Obara, T., Ishiguro, A., Murakami, K., Matsuda, A., Yasui, D., Murakami, T., Mano, N., Imai, Y., Ohkubo, T. Tags: Epidemiology, Cerebrovascular Disease/Stroke Epidemiology/Population Source Type: research

Impact of Comorbidities on Acute Injury and Recovery in Preclinical Stroke Research: Focus on Hypertension and Diabetes
Abstract Human ischemic stroke is very complex, and no single preclinical model can comprise all the variables known to contribute to stroke injury and recovery. Hypertension, diabetes, and hyperlipidemia are leading comorbidities in stroke patients. The use of predominantly young adult and healthy animals in experimental stroke research has created a barrier for translation of findings to patients. As such, more and more disease models are being incorporated into the research design. This review highlights the major strengths and weaknesses of the most commonly used animal models of these conditions in preclinica...
Source: Translational Stroke Research - March 29, 2016 Category: Neurology Source Type: research

Beta-blockers are not associated with stroke severity and outcome in hypertensive patients: data from a national stroke registry
Lowering blood pressure (BP) with beta-blockers is less effective in reducing the risk of stroke than with other agents. However, studies on associations between use of beta-blockers and stroke severity are inconclusive. We assessed the association between pre-stroke use of beta-blockers and stroke severity, disability and death in a large prospective national registry of hospitalized hypertensive patients with acute stroke.
Source: Journal of the American Society of Hypertension - March 31, 2016 Category: Cardiology Authors: Ehud Grossman, David Tanne, Silvia Koton Tags: Stroke Source Type: research

Accelerated development of cerebral small vessel disease in young stroke patients
Conclusions: Patients with a young stroke have a higher burden of small vessel disease than controls adjusted for confounders. Cerebral aging seems accelerated by 10–20 years in these patients, which may suggest an increased vulnerability to vascular risk factors.
Source: Neurology - September 18, 2016 Category: Neurology Authors: Arntz, R. M., van den Broek, S. M. A., van Uden, I. W. M., Ghafoorian, M., Platel, B., Rutten-Jacobs, L. C. A., Maaijwee, N. A. M., Schaapsmeerders, P., Schoonderwaldt, H. C., van Dijk, E. J., de Leeuw, F.-E. Tags: Stroke in young adults, Prognosis ARTICLE Source Type: research