JAHA Conference Reads
27th European Meeting on Hypertension and Cardiovascular Protection
To coincide with the 27th European Meeting on Hypertension and Cardiovascular Protection (ESH 2017), the JAHA Editors have selected 5 related articles.
Mark Canney, Matthew D. L. O'Connell, Donal J. Sexton, Neil O'Leary, Rose Anne Kenny, Mark A. Little, Conall M. O'Seaghdha
In this article, Canney et al. evaluates the relationship between renal function and orthostatic hypotension. They show that a) subjects with an eGFR ‹60 ml/min-1.73m2 were twice as likely to have a sustained drop in blood pressure, and b) that there was a graded association between renal function and orthostatic hypotension. These findings suggest that patients with renal insufficiency are at increased risk for injury due to falls.
Ying Yang, Fangchao Liu, Long Wang, Qian Li, Xingyu Wang, Julia C. Chen, Qiaomei Wang, Haiping Shen, Yiping Zhang, Donghai Yan, Man Zhang, Yuan He, Zuoqi Peng, Yuanyuan Wang, Jihong Xu, Jun Zhao, Ya Zhang, Hongguang Zhang, Xiaona Xin, Yan Wang, Dujia Liu, Tongjun Guo, Qiaoyun Dai, Xu Ma
In this article, Yang et al. seeks to identify the effects of second hand smoke in Chinese women. They show that women whose husbands smoked had a higher risk of hypertension, and that the risk was related to the number of cigarettes smoked. These findings suggest that smoking cessation has benefits for the family of the smoker.
Mai Tone Lønnebakken, Raffaele Izzo, Costantino Mancusi, Eva Gerdts, Maria Angela Losi, Grazia Canciello, Giuseppe Giugliano, Nicola De Luca, Bruno Trimarco, Giovanni de Simone
This article by Lønnebakken et al. seeks to identify those factors that make left ventricular hypertrophy (LVH) irreversible in patients with hypertension. They show that suboptimal blood pressure control, higher baseline LV mass index, older age, female sex, and obesity correlated with persistence of LVH. These findings suggest that early and aggressive treatment of hypertension are critical in the prevention of irreversible LVH and poorer outcomes.
Xianhui Qin, Youbao Li, Ningling Sun, Mingli He, Genfu Tang, Delu Yin, JiGuang Wang, Min Liang, Binyan Wang, Yong Huo, Xin Xu, Xiping Xu, Fan Fan Hou
This article by Qin et al. studies the relationship between successful lowering of blood pressure in patients with grade 1 hypertension and stroke risk. They show that an increased proportion of study visits with blood pressure < 140/90 was associated with a) a lower stroke risk and b) a lower all-cause mortality. These findings suggest successful treatment of hypertension decreases neurological morbidity and mortality.
Henrique C.S. Muela, Valeria A. Costa‐Hong, Mônica S. Yassuda, Natália C. Moraes, Claudia M. Memória, Michel F. Machado, Thiago A. Macedo, Edson B.S. Shu, Ayrton R. Massaro, Ricardo Nitrini, Alfredo J. Mansur, Luiz A. Bortolotto
In this article, Muela et al. seeks to identify changes in cognitive function that are related to hypertension. They show that patients with severe hypertension had impaired performance on two cognitive performance based and on neuropsychological tests. These findings suggest that hypertension leads to end-organ damage in the brain in the absence of stroke.
3rd European Stroke Organisation Conference Collection
To coincide with the 3rd European Stroke Organisation Conference, the JAHA Editors have selected 5 related articles.
Johannes Kaesmacher, Christian Maegerlein, Mirjam Kaesmacher, Claus Zimmer, Holger Poppert, Benjamin Friedrich, Tobias Boeckh‐Behrens, Justus F. Kleine
In this article, Kaesmacher et al. evaluate the frequency of thrombus migration in patients with left middle cerebral artery stroke prior to interventional endovascular therapy. They show a) clot migration is common; b) that recombinant tissue plasminogen activator (rTPA) does not increase the frequency of clot migration; and c) that patients with clot migration have lower rates of complete reperfusion with intervention and worse outcomes. These findings suggest that thrombus migration on serial imaging studies is a negative prognostic factor in this subset of strokes.
Konrad Koch, Dirk Berressem, Jan Konietzka, Anna Thinnes, Gunter P. Eckert, Jochen Klein
Koch et al evaluate the effect of stroke (caused by middle cerebral artery occlusion for 90 minutes followed by reperfusion) in mice on normal and fat-rich diets. They show that a) mice on fat-rich diets have increased β‐hydroxybutyrate (ketone bodies) and less glucose in the liver, plasma, and brain during ischemia, and reversal towards baseline during reperfusion; and b) that the β -adrenergic blocker propanolol prevents these changes. These findings suggest that diet and cardiac medications may influence substrate availability to the brain during stroke.
Lu Ban, Nikola Sprigg, Alyshah Abdul Sultan, Catherine Nelson‐Piercy, Philip M. Bath, Jonas F. Ludvigsson, Olof Stephansson, Laila J. Tata
In this article, Ban and colleagues evaluate the incidence of a first stroke during pregnancy and the period around childbirth. They show that a) strokes are rare at baseline; b) the risk of stroke (both ischemic and hemorrhagic) is decreased throughout pregnancy (0.5-0.8 fold); and c) the risk of stroke is significantly increased during the peripartum (2 days before to 1 day after birth; 9-fold) and early postpartum period (first 6 weeks after birth; 3-fold). These findings suggest that the risk of stroke is markedly increased during the period around childbirth but not during pregnancy.
Sofie Schmid, Pavlos Tsantilas, Christoph Knappich, Michael Kallmayer, Thomas König, Thorben Breitkreuz, Alexander Zimmermann, Andreas Kuehnl, Hans‐Henning Eckstein
In this article, Schmid and colleagues evaluate the effect of age and sex on stroke and death in a large German cohort treated by carotid endarterectomy. They show that a) stroke (1.4%) and death (0.6%) are uncommon; b) older age is associated with a significantly greater risk of death (1.7 fold over 10 years), but with only a marginally increased risk of stroke (1.05 fold over 10 years); and c) that sex is not associated with a difference in death and/or stroke. These findings suggest that carotid endarterectomy is equally safe for men and women.
Ralph L. Sacco, Hannah Gardener, Kefeng Wang, Chuanhui Dong, Maria A. Ciliberti‐Vargas, Carolina M. Gutierrez, Negar Asdaghi, W. Scott Burgin, Olveen Carrasquillo, Enid J. Garcia‐Rivera, Ulises Nobo, Sofia Oluwole, David Z. Rose, Michael F. Waters, Juan Carlos Zevallos, Mary Robichaux, Salina P. Waddy, Jose G. Romano, Tatjana Rundek, the FL‐PR CReSD Investigators and Collaborators
The article by Sacco et al. evaluates stroke care by racial group in Florida and Puerto Rico. They show that a) the quality of stroke care was similar in non-Hispanic blacks, non-Hispanic whites, and Hispanics in Florida, but lower in Hispanics in Puerto Rico; and b) stroke care markedly improved in all locations between 2010 and 2014, although the disparities in Puerto Rico remained. These findings suggest that in Florida and Puerto Rico, regional disparities in care outweigh those based on racial-ethnic groups.