How To Treat Atrial Fibrillation Induced Stroke?

Being an irregular heartbeat, atrial fibrillation (AF) is the commonest heart rhythm problems in cardiological clinical practice. People with AF will have abnormal beat of the upper chambers of the heart, causing stagnation of blood in the left upper chamber. Clots can then be formed and be carried in the bloodstream to the brain. The consequence is a large area of brain is damaged and permanent disability and even dead could be resulted. More importantly, an AF-induced stroke can be recurrent.

About 1 percent of the population has AF, which is the cause for 1 in 5 stroke cases. The chance for octogenarians to get an AF is 15 percent. Congestive heart failure, diabetes, high blood pressure, valve disease, coronary artery disease are some other conditions associated with AF.

While some people with AF can have symptoms such as heart palpitations, shortness of breath and tiredness, some might not feel anything at all. Taking appropriate anticoagulation drugs to prevent blood clots can actually reduce AF-induced stroke by 60 percent.

It is not recommended to prescribe anticoagulation drugs like Warfarin to patients who are not aware that they have AF, and do not have at least one of the risk factors like advanced age, hypertension, diabetes, prior history of stroke, and presence of heart failure. This is to avoid possible bleeding risk and side effects.

Fortunately, new drugs like Rivaroxaban (brand name Xarelto) have been proven to be easier to use and more effective than Warfarin. In fact, Rivaroxaban is a single fixed dosage that does not require monitoring.

In Germany, about 45 percent of the elderly with AF are not prescribed with blood thinners in fear of bleeding risk. But with Rivaroxaban, the risk of fatal bleeding is cut by 50 percent and the risk of intracranial bleeding is reduced by 35 percent. It is also 20 percent better than Warfarin in lowering stroke and systemic embolism.

But in reality, the biggest problem in preventing AF-related stroke is detecting AF itself. Many patients have no syndromes hence they do not even get diagnosed by ECG (electrocardiogram) that can detect AF for people having AF symptoms.

Meanwhile, there is a so-called temporary and transient AF, which can come and go, yet carry the same stroke risk. Unfortunately, doctors would only prescribe a blood thinner to patients who are confirmed by an ECG that they have an irregular heartbeat, and it is not a usual practice for patients to take ECGs on a regular basis just to detect AF.

AF is a tricky disease that carries a high stroke risk. But it is now possible, with the help of new drugs like Rivaroxaban that is effective and safe to take, to substantially reduce the stroke risks linked to AF.

Is Bariatric Surgery Good For The Heart?

Every year, more than 2.6 million people die because of being obese or overweight. A person who is obese or overweight could be high-risk victim of many chronic diseases including heart disease, stroke, hypertension (high blood pressure), Type-2 diabetes and even certain kinds of cancer.

When diet and exercise fail to lower the extra weight in the body, bariatric surgery is usually done especially when serious health problems arise because of the weight. The purpose of such surgery is to help lose weight by limiting how much one can eat or by reducing the absorption of nutrients, or both.

According to a study published on October 17, 2012 in journal ‘Heart’, bariatric surgery not only helps the obese cut the weight but also reduces risks of heart disease and stroke within a short period of time.

 from the Cleveland Clinic in Cleveland, Ohio, picked up and analyzed 73 previous studies, covering nearly 20,000 people, which recorded weight and other health issues before and after bariatric surgery. 3 out of 4 of the patients were women, whose average age was 41.

They found that after the operation, participants lost on average 54 percent of their excess weight. 63, 73 and 65 percent of the patients showed improvement in high blood pressure, diabetes and blood cholesterol respectively.

The researchers also selected and reviewed a further 18 studies, covering 713 other patients, and found that bariatric surgery did lead to improvements in the heart function, like its ability to pump out and refill with blood.

Nevertheless, the review did have some limitations. For instance, it did not look at the same operative techniques or share the same criteria for measuring improvements, and there were also no follow-up or monitoring patients for a long time after their operation.

Yet according to the researchers, their analysis indicated that bariatric surgery is not just a cosmetic procedure but also a potentially life-saving alternative for the appropriate patients.

A word of caution is that bariatric surgery is a major procedure that could pose serious risks and side effects. Statistics show that there is a 0.3 percent risk of death, a 5 percent risk of intestinal obstruction and an 8 percent risk of an ulcer.

Hypertension Might Be Curbed By Egg White!

Eggs supply all essential amino acids for humans (a source of complete protein), and provide several vitamins like A, B2, B9, B6, and B12 and minerals including choline, iron, calcium, and potassium. Eggs are also a source of CoQ10 depending on how they are prepared.

Only 27 percent of the fat in egg is saturated fat that contains LDL cholesterol. The egg white consists primarily of water (87 percent) and protein (13 percent). There is no cholesterol and little, if any, fat found in the egg white.

Egg yolk is often tied with high bad cholesterol, and that is why general population, especially those who are on a low-cholesterol diet, is advised not to consume too many eggs. High bad cholesterol is often linked to heart disease, stroke, and hypertension (high blood pressure).

Nevertheless, scientists have found that a component of egg might have another beneficial effect in reducing blood pressure.

At the 245th National Meeting & Exposition of the American Chemical Society in New Orleans, United States held between April 7 and 11, 2013, researchers from Jilin University in China and Clemson University reported that a substance in egg white has a powerful ability to inhibit or block the action of angiotensin converting enzyme (ACE), a substance produced in the body naturally to raise blood pressure.

The substance is a peptide, which is one of the building blocks of proteins. In the experiments on rats with hypertension, this peptide called RVPSL did not show any toxic effects and it lowered blood pressure by amounts comparable to those achieved by a low dose of a high blood pressure drug.

RVPSL used in the experiment was heated to almost 200 degrees Fahrenheit during preparation, which is slightly lower than the temperatures at which eggs are typically cooked. Past research had shown that egg whites have positive effects on blood pressure even after they are fully cooked.

For instance, a study published in the ACS’ Journal of Agricultural and Food Chemistry, indicated that fried egg protein had greater capacity of lowering blood pressure than eggs cooked at 212 degrees Fahrenheit.

Researchers thought that egg white peptides could become valuable as a supplement to blood-pressure drugs, and the study could add to recent restoration of eggs’ reputation. But they cautioned that hypertensive patients should check with their doctors before making any adjustments to their diet.

Recently, many other studies have found that most people could include eggs in their diet without increasing their blood cholesterol levels, while benefiting from eggs’ low-cost protein, vitamins and other nutrients.

Bacteria Could Cause Obesity!

A number of things could lead to overweight or even obesity, for instance, high fat diet, lack of physical activities, genes, or lack of sleep. Researchers in Shanghai, China recently reported that obesity could be caused by bacterial infection.

In a paper published on 13 December 2012 by ‘Journal of the International Society for Microbial Ecology’, researchers from Shanghai Jiao Tong University found that mice bred to be resistant to obesity even when fed high-fat foods became excessively overweight when injected with a kind of human bacterium and fed with a rich diet.

After following an 8-year search by scientists around the world to explain the association between gut bacteria and obesity, the Chinese researchers identified a human bacterium that caused obesity. The bacterium, which is also known as enterobacer, encourages the body to make and store fat, and prevents it from being used by deregulating the body’s metabolism-controlling genes.

Enterobacter also release chemicals, called endotoxins, which cause insulin resistance and a slower uptake of glucose from the blood after eating. Patients tend to eat more since they take longer to feel full.

As part of the experiment, mice were injected with the bacterium that was found in high quantities in the gut of a morbidly obese human volunteer for up to 10 weeks. Their weight gain was compared with mice without feeding with the bacterium. The latter did not become obese despite being fed with a high-fat diet and being prevented from exercising. Results of the experiment showed that the bacterium might causatively contribute to the development of obesity in humans.

The study also found that the human volunteer, who was prevented from doing any exercise, lost 29 percent of his body weight in 23 weeks after being placed on a special diet that cut the bacterium's presence in his gut to undetectable levels. The volunteer also recovered from diabetes, high blood pressure and fatty liver disease.

Diet used in the trial, including whole grains, traditional Chinese medicinal foods and non-digestible carbohydrates, changed the pH in the gut that limited the bacterium’s activity.

Since 1980, obesity worldwide has more than doubled, according to the World Health Organization (WTO). Overweight or obese people are at a higher risk of suffering from heart disease, stroke, cancer, and diabetes.

According to other heath experts not involved in the study, it is possible that the bacteria could be infectious and picked up from some unknown environmental factor, or a parent, and it might not be behavioral after all. The new findings could highlight a way to intervene in obesity and could allow new drugs to be developed for treatment.

Can Mobile Phone Help Smoker Quit?

Smoking is bad for the health as it harms almost all organs of the body. It will lead to many diseases including lung cancer, COPD (chronic obstructive pulmonary disease), heart disease and stroke. The secondhand smoke from smokers’ cigarettes can also cause many of these diseases to people around them.

Governments around the world have been actively finding means and ways to suppress smoking rate by educating smokers as well as implementing smoking bans (or some called smoke-free laws).

According to a New Zealand’s study, text and video messages that appeared on mobile phones and designed to help people quit smoking almost doubled the success rate for attempted quitters, comparing with people who did not have such assistance.

The findings, which were published on November 14, 2012 in ‘The Cochrane Library’, reported that 9 percent of intended quitters stopped smoking for at least 6 months when reminded and encouraged through mobile phone messages, compared to 5 percent who did not have such service.

Mobile phone programs involved a text message or video conveying motivation and advice sent to smokers every day for several weeks to prepare them for the designated quit day. After the quit day, multiple messages were often sent to intended quitter each day for weeks. The messages offered encouragement, tips on getting through cravings and additional resources to quit again after a relapse.

Researchers from the University of Auckland in New Zealand and other institutions reviewed 5 studies and compared mobile phone messaging to no extra help.

A total of 9,100 smokers were tracked for 6 months. Among 4,730 participants assigned to a text or video messaging program, 444 managed to kick the habit. On the other hand, 240 out of the 4,370 participants who did not receive any additional services stopped smoking for 6 months.

Quit smoking requires a great deal of effort and most people require few attempt to quit. Many of the intended quitters still continue smoking even if they have tried a texting program. Nevertheless, the mobile texting programs are automated and easy to scale up for widespread use. It is important to offer smokers as many tools as possible to help them quit smoking.

Eat Fish Might Prolong Your Life!

Eating fish is good for health. As recommended by the American Heart Association (AHA), people should consume every week two 3.5-ounce servings of fatty fish, such as salmon, mackerel, herring, sardines and tuna, that are high in omega-3 fatty acid.

In a paper that was published on April 1, 2013’s in the journal ‘Annals of Internal Medicine’, researchers from Harvard School of Public Health reported that people aged 65 and older who eat fish might live an average of 2 years longer than people who do not consume the omega-3 fatty acids.

The study also showed that people with higher level of omega-3 fatty acids had 27 percent lower overall risk of dying and 35 percent lower risk of dying from heart disease, comparing to those who had lower levels of omega-3 fatty acid.

To determine whether there is any link between fish eating and risk of death, researchers scanned 16 years of data on about 2,700 American adults aged 65 or older. Those taking fish oil supplements were eliminated to avoid confusion over the use of supplements or dietary differences. During the 16-year of follow up, 1625 people died including 570 from cardiovascular disease.

Participants with highest levels of omega-3 fatty acids in the blood had the lowest risk of dying from any cause, and they lived an average of 2.2 years longer than those with low levels.

3 forms of omega-3 fatty acids were identified in the study. DHA (docosahexaenoic acid) was most strongly associated with a lower risk of death from coronary heart disease, EPA (eicosapentaenoic acid) was strongly related to a lower risk of non-fatal heart attack, and DPA (docosapentaenoic acid) was most strongly linked to a lower risk of dying from a stroke.

Nevertheless, the researchers stressed that their study noted an association without establishing a cause-and-effect relationship. They could not determine if the omega-3 intake was directly responsible for the reduced risk of death or just a marker for a healthier lifestyle.

For example, people having the highest level of omega-3 also had consumed more fruit and vegetables than those having a lower level of omega-3. This also suggested that simply taking a fish oil supplement might not produce the same effect.

Those who are currently not fish eaters need not worry because they can always start some intake of fish and should be able to get most of the benefit for their blood level, according to researchers.

Can Fiber Prevent Stroke?

When a person has a stroke, his or her brain function is losing rapidly because of disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage or a hemorrhage (rupture of a blood vessel or an abnormal vascular structure). About 87 percent of strokes are caused by ischemia.

Stroke is the second leading cause of death worldwide. As reported by the Centers for Disease Control and Prevention (CDC), almost 800,000 people in the United States suffer stroke that causes 1 out of every 18 deaths, or 130,000 deaths each year.

But stroke is preventable. According to researchers from the University of Leeds in the United Kingdom, people who have more fiber intake are less likely to suffer from a stroke.

Results of 8 studies, conducted between January 1990 and May 2012 in the United States, Japan, Europe and Australia involving around 500,000 participants, were pulled together into one analysis. Researchers spent between 8 and 19 years following those people who reported on their dietary fiber intake.

Analysis showed that the risk of getting the first stroke decreased by 7 percent for every 7-gram increase in the reported fiber consumption each day. Those who had the most fiber intake had the lowest risk of getting stroke. Even just 2 or 3 grams of fiber per day might affect the stroke risk. The findings were published online on March 28, 2013 in the journal ‘Stroke’.

The study neither proved that eating fiber could directly prevent stroke nor why fiber would be linked to a lower risk of stroke. But it is possible that food high in fiber tends to be low-calorie and helps keep a healthy weight, which in turn lowers stroke risk. In addition, fibrous food has vitamins, minerals and antioxidants, including polyphenols and flavonoids that might make blood vessels more elastic.

In the United States, an average woman consumes 13 grams of fiber and average man gets 17 grams each day. Apparently these are not enough. Institute of Medicine recommends 35 grams for men and 24 grams for women aged 50 and below, and 30 grams and 21 grams for men and women aged above 50 respectively.

It is hoped that the new findings would encourage people to eat more fiber so as to reach the daily-recommended amount. Getting 7 grams of fiber is not really difficult: people just need to eat 2 slices of whole wheat bread and a serving of fruit.

How Can Psoriasis Raise Diabetes Risk?

Being a lifelong condition, psoriasis is an immune-mediated disease that affects the skin. People with psoriasis will have their skins filled with thick silvery scales and feel itchy, dry and sometimes painful. Psoriasis is, however, not contagious.

There are 5 types of psoriasis namely, plaque, guttate, inverse, pustular, and erythrodermic. The most common form is plaque psoriasis. More than 3 percent of adults in the United States have psoriasis, according to the National Institutes of Health (NIH).

For some people, psoriasis is just a nuisance. However, a review, which appeared in January 2013 in the ‘Archives of Dermatology’, reported that patients with psoriasis had up to an almost 4-fold higher risk of developing Type-2 diabetes than those without the skin condition.

Researchers from the University of California, Davis reviewed results of 27 past observational studies from around the world and found that people with psoriasis were 59 percent more likely to have Type-2 diabetes than control participants. In particular, those with severe psoriasis were almost twice as likely to have diabetes. In the 5 studies that tracked diabetes-free people, those with psoriasis were 27 percent more likely to develop diabetes than others without the skin disease.

Health experts believe that the chronic, body-wide inflammation behind psoriasis might also be responsible for raising a person's risk of diabetes, as well as heart disease and stroke. Past research has already associated psoriasis with higher risk of having heart disease or suffering a heart attack or stroke. However, they are not sure how psoriasis is linked to these diseases.

The review also indicated that people with psoriasis tend to be heavier, more depressed and less physically active than those without the condition, which could increase their underlying diabetes risk.

Currently, there is no cure but various treatments can help control the symptoms. For example, lifestyle measures, such as using a nonprescription cortisone cream and exposing the skin to small amounts of natural sunlight, can improve psoriasis symptoms. As psoriasis has been linked to an increased risk of stroke, treating high blood lipid levels might also lead to improvement.

In another study of more than 500,000 people in the United Kingdom, which was released in June 2012, also linked severe psoriasis with a 46 percent increased risk of diabetes.

As people with psoriasis may not know about the risks they are facing, the researchers recommended extra diabetes screening and education about these risks for people with the skin condition.