Category Archives: stroke

Prevent Cardiovascular Events By Taking Hypertension Meds at Bedtime

High blood pressure is linked to heart attacksVery

This may be the most important biomedical research of 2019. Very recently I have noticed hypertension patients taking their medications at bedtime. Now I know why.

From Medscape:

Taking antihypertensive medication at bedtime led to an almost halving of cardiovascular events in a new study.

The Hygia Chronotherapy Trial is the largest ever study to investigate the effect of the time of day when people take their antihypertensive medication on the risk of cardiovascular events.

The trial randomly assigned 19,084 patients to take their medication on waking or at bedtime and followed them for an average of 6 years.Results showed that patients who took their pills at bedtime had a 45% reduction in overall cardiovascular events. This included a 56% reduction in cardiovascular death, a 34% reduction in myocardial infarction (MI), a 40% reduction in coronary revascularization [bypass surgery and angioplasty/stenting], a 42% reduction in heart failure, and a 49% reduction in stroke, all of which were statistically significant.

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“We showed that if blood pressure is elevated during sleep then patients have increased cardiovascular risk regardless of daytime pressure, and if blood pressure during sleep is normal then cardiovascular risk is low even if the [doctor’s] office pressure is elevated,” Hermida said.

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Results showed that during the 6.3-year median patient follow-up, 1752 participants experienced the primary cardiovascular disease (CVD) outcome (a composite of CVD death, MI, coronary revascularization, heart failure, or stroke).

Drug classes as physicians’ disposal were ARBs (angiotensin receptor blockers, calcium channel blockers, ACE inhibitors, and diuretics. Preventative effects were most pronounced for ARBs and ACE inhibitors.

Don’t change your BP medication dosing until you check with your personal physician.

Source: Bedtime Dosing of Hypertension Meds Reduces CV Events

Did you know most heart attacks occur in the morning, and those tend to be the most serious?

Steve Parker, M.D.

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Diet Quality Affects Risk of Cardiovascular Disease in Post-Menopausal Diabetic Women

Not your average cave-woman

Regarding the mention of paleo diet below, I rather doubt the study at hand hand significant numbers of paleo diet followers. From the Journal of the American Heart Association:

ABSTRACT

Background Dietary patterns are associated with cardiovascular disease (CVD) risk in the general population, but diet-CVD association in populations with diabetes mellitus is limited. Our objective was to examine the association between diet quality and CVD risk in a population with type 2 diabetes mellitus.

Methods and Results

We analyzed prospective data from 5809 women with prevalent type 2 diabetes mellitus at baseline from the Women’s Health Initiative. Diet quality was defined using alternate Mediterranean, Dietary Approach to Stop Hypertension, Paleolithic, and American Diabetes Association dietary pattern scores calculated from a validated food frequency questionnaire. Multivariable Cox’s proportional hazard regression was used to analyze the risk of incident CVD. During mean 12.4 years of follow-up, 1454 (25%) incident CVD cases were documented. Women with higher alternate Mediterranean, Dietary Approach to Stop Hypertension, and American Diabetes Association dietary pattern scores had a lower risk of CVD compared with women with lower scores (Q5 v Q1) (hazard ratio [HR]aMed 0.77, 95% CI 0.65-0.93; HRDASH 0.69, 95% CI 0.58-0.83; HRADA 0.71, 95% CI 0.59-0.86). No association was observed between the Paleolithic score and CVD risk.

Conclusions

Dietary patterns that emphasize higher intake of fruits, vegetables, whole grains, nuts/seeds, legumes, a high unsaturated:saturated fat ratio, and lower intake of red and processed meats, added sugars, and sodium are associated with lower CVD risk in postmenopausal women with type 2 diabetes mellitus.

Source: Diet Quality and Cardiovascular Disease Risk in Postmenopausal Women With Type 2 Diabetes Mellitus: The Women’s Health Initiative. – PubMed – NCBI

Steve Parker, M.D.

Click pic to purchase book at Amazon.com. E-book versions available at Smashwords.com.

Raman May Increase Risk of Fatal Stroke

…at least if you’re Japanese. I rarely eat ramen, but understand it’s fairly popular among young adults in the U.S, particularly among college students, because it’s cheap, quick, and tasty.

Click for details of the study in Nutrition Journal. Some background from the article:

Ramen is one of the most popular foods in Japan, despite being of Chinese origin [11]. Since its original introduction in Japan, ramen has been adapted and now consists of wheat noodles served in broth topped with sliced pork, seaweed, or menma (a Japanese condiment made from lacto-fermented bamboo shoots; Additional file 1). Being tasty and inexpensive, ramen became a popular food that was available from street food stands in Japan after World War ΙΙ. Although the number of ramen stands has decreased markedly, ramen remains highly popular in Japan. High dietary sodium content was recently reported to be a risk factor for stroke [12]; ramen has a high sodium content. However, the relationship between stroke and ramen consumption remains unclear. In this study, we investigated the association between the number of ramen restaurants in each Japanese prefecture and stroke mortality in that prefecture.

Steve Parker, M.D.

Click pic to purchase book at Amazon.com. E-book versions available at Smashwords.com.