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7 results

  • Eating habits in the population of the Aeolian Islands: an observational study

  • Paolo La Spina, Rodolfo Savica, Antonio Ciacciarelli, Masina Cotroneo, Cristina Dell’Aera, Francesco Grillo, Carmela Casella, Maria Carolina Fazio, Giuseppe Trimarchi, Rosa Fortunata Musolino
  • Journal:
    Public Health Nutrition / Volume 22 / Issue 9 / June 2019
    Published online by Cambridge University Press:
    26 December 2018, pp. 1590-1596
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  • Objective

    We conducted a study to describe food profile, health status and stroke risk factors in the population of the Aeolian Islands.

    Design

    Self-administrated questionnaires regarding eating habits, health status and stroke risk factors were obtained from a sample of the general Aeolian population. We analysed the difference from common healthy eating habits indicated by the Italian Institute of Nutrition.

    Setting

    Current evidence finds the Mediterranean diet is a protective factor for cardio- and cerebrovascular diseases. The Aeolian Islands are an interesting study setting because of their peculiarity in the epidemiology of cerebrovascular and neurodegenerative diseases.

    Participants

    Individuals (n 586; age range 15–93 years; mean 52 (sd 18) years) living in the Aeolian Islands.

    Results

    We found low fish consumption in 13·3% and vitamin intake deficiency in 5·8% of participants. A marked excess of saturated fats was observed in 71·0% of participants. Sodium excess was reported almost in half of participants (49·0%). Eating habits were characterized by high consumption of fruits and vegetables, consistent use of olive oil and scanty use of cured meat. Health status as evaluated by the General Health Questionnaire was characterized by ‘normal distress’ level in the majority of participants.

    Conclusions

    Study findings show the eating habits and health status of the Aeolian people in an interesting setting of low incidence of cerebrovascular disease. This nutrition regimen has been proved to be protective against cerebrovascular disease. Nutrition is likely to contribute to the low incidence of stroke in this population.

  • Are Parkinson’s Patients More Vulnerable to the Effects of Cardiovascular Risk: A Neuroimaging and Neuropsychological Study

  • Jacob D. Jones, Jared J. Tanner, Michael Okun, Catherine C. Price, Dawn Bowers
  • Journal:
    Journal of the International Neuropsychological Society / Volume 23 / Issue 4 / April 2017
    Published online by Cambridge University Press:
    06 February 2017, pp. 322-331

  • Objectives: This study examined whether individuals with Parkinson’s disease (PD) are at increased vulnerability for vascular-related cognitive impairment relative to controls. The underlying assumption behind this hypothesis relates to brain reserve and that both PD and vascular risk factors impair similar fronto-executive cognitive systems. Methods: The sample included 67 PD patients and 61 older controls (total N=128). Participants completed neuropsychological measures of executive functioning, processing speed, verbal delayed recall/memory, language, and auditory attention. Cardiovascular risk was assessed with the Framingham Cardiovascular Risk index. Participants underwent brain imaging (T1 and T2 FLAIR). Trained raters measured total and regional leukoaraiosis (periventricular, deep subcortical, and infracortical). Results: Hierarchical regressions revealed that more severe cardiovascular risk was related to worse executive functioning, processing speed, and delayed verbal recall in both Parkinson patients and controls. More severe cardiovascular risk was related to worse language functioning in the PD group, but not controls. In contrast, leukoaraiosis related to both cardiovascular risk and executive functioning for controls, but not the PD group. Conclusions: Overall, results revealed that PD and cardiovascular risk factors are independent risk factors for cognitive impairment. Generally, the influence of cardiovascular risk factors on cognition is similar in PD patients and controls. (JINS, 2017, 23, 322–331)

  • Chapter 9 - Sleep apnea and acute stroke deterioration

  • Edited by Antonio Culebras
  • Book:
    Sleep, Stroke and Cardiovascular Disease
    Published online:
    05 January 2013
    Print publication:
    06 December 2012, pp 104-114

  • Summary

    This chapter discusses the interactions between obstructive sleep apnea syndrome (OSAS) and cardio- and cerebrovascular diseases, focusing on the mechanisms by which OSA may contribute to the onset and progression of cardiovascular diseases. The autonomic nervous system (ANS) is closely related to sleep from anatomical, physiological and neurochemical points of view, resulting in dynamic synchronous fluctuations in sleep phases and autonomic functions. Analysis of the circadian rhythm of heart rate variability shows that the mean high-frequency value from morning to noon is lower, whereas the mean low-frequency/high-frequency ratio is higher in OSAS patients than in controls. Measuring ANS function by means of spontaneous baroreflex cardiac modulation or other methods may not only help recognize the severity and prognostic relevance of the cardiovascular effect of OSA, but can shed light on the pathophysiological mechanisms that transform transient nocturnal alterations into sustained 24-hour derangements that require treatment.

  • Chapter 32 - Anterior choroidal artery territory strokes

  • from Section 2 - Vascular topographic syndromes
  • Edited by Louis R. Caplan, Jan van Gijn
  • Book:
    Stroke Syndromes, 3ed
    Published online:
    05 August 2012
    Print publication:
    12 July 2012, pp 375-386

  • Summary

    The recognition of cardiac complications after stroke is of essence for the clinician, as the anticipation of such can guide clinical management and significantly alter patient outcomes after stroke. This chapter focuses mainly on the effects of the brain on the heart, discussing the neuroanatomical and pathophysiological correlates of these conditions, and their clinical and management implications. Pathophysiologically, the major underlying mechanism for myocardial damage in contraction band necrosis is felt to be sudden entry of calcium into the myocytes. Calcium deficiency with loss of intracellular calcium, anoxia followed by reoxygenation of the electron transport system, ischemia followed by reperfusion, or opening of the receptor-operated calcium channels by excessive amounts of locally released norepinephrine can lead to the final common pathway to cell death. Hypertension has been consistently shown in the acute phase of cerebrovascular diseases, even in patients who do not have a prior history of hypertension.

  • Chapter 10 - Neurological complications of systemic disorders

  • Edited by S. Andrew Josephson, University of California, San Francisco, W. David Freeman, David J. Likosky
  • Book:
    Neurohospitalist Medicine
    Published online:
    07 October 2011
    Print publication:
    29 September 2011, pp 142-152

  • Summary

    This chapter reviews the pathology, epidemiology, treatment and management of Intracerebral hemorrhage and subarachnoid hemorrhage (SAH). Hypertensive intracerebral hemorrhages typically occur in territories perfused by deep perforating arteries coming off the basal cerebral arteries. The advent in early use of CT imaging, however, has documented expansion of intracerebral hemorrhage in almost 40% of the cases. The role of surgery for supratentorial hemorrhages has been extensively evaluated in the management of intracerebral hemorrhage, with most of these studies showing no benefit of surgical evacuation of the hematoma. There are approximately 25-30,000 patients a year with SAH. The initial management strategy for the patient after SAH is to stabilize the patient until the cerebral aneurysm can be identified and secured. Interventional procedures may be needed to open constricted cerebral blood vessels if medical maneuvers are insufficient to improve or prevent the onset of neurological deficits due to vasospasm.

  • Chapter 18 - Other clinical manifestations of cerebralmicrobleeds

  • from Section 3 - Microbleeds in relation to specific populations, diseases and neurological symptoms
  • Edited by David J. Werring, Institute of Neurology, London
  • Book:
    Cerebral Microbleeds
    Published online:
    05 July 2011
    Print publication:
    26 May 2011, pp 159-164

  • Summary

    This chapter provides an overview of the prevalence and associations, temporal evolution and prognostic significance of cerebral microbleeds (CMBs) in patients with cerebrovascular diseases. The spatial distribution of microbleeds, as markers of small vessel microhemorrhagic or microaneurysmal lesions, may be of particular interest in attempts to understand the causes of macroscopic intracerebral hemorrhage (ICH) in life. Cerebral amyloid angiopathy is an important cause of primary ICH, particularly of lobar location. Chronic hypertension has been repeatedly identified as a strong influence on the frequency and extent of CMBs, in patients with established stroke as well as in healthy subjects without stroke. Hypertension is an important risk factor for CMBs. As CMBs reflect the bleeding tendency of the brain through fragile microvascular walls, interest has increased in utilizing CMBs in risk stratification of hemorrhagic complications for patients with antithrombotic treatment.

  • Plant foods and the risk of cerebrovascular diseases: a potential protection of fruit consumption

  • Anna Mizrahi, Paul Knekt, Jukka Montonen, Maarit A. Laaksonen, Markku Heliövaara, Ritva Järvinen
  • Journal:
    British Journal of Nutrition / Volume 102 / Issue 7 / 14 October 2009
    Published online by Cambridge University Press:
    31 July 2009, pp. 1075-1083
    Print publication:
    14 October 2009
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  • Studies on the association between plant foods and cerebrovascular diseases have given contradictory results suggesting the existence of some effect-modifying factors. The present study determines whether the consumption of plant foods (i.e. fruits and berries, vegetables, and cereals) predicts a decreased cerebrovascular disease incidence in a population with low fruit and vegetable and high wholegrain intake. This cohort study on 3932 men and women was based on data from the Finnish Mobile Clinic Health Examination Survey, conducted in 1968–72. The participants were 40–74 years of age and free of cardiovascular diseases at baseline. Data on the plant food consumption were derived from a 1-year dietary history interview. During a 24-year follow-up 625 cases of cerebrovascular diseases occurred, leading to either hospitalisation or death. An inverse association was found between fruit consumption and the incidence of cerebrovascular diseases, ischaemic stroke and intracerebral haemorrhage. The adjusted relative risks (RR) between the highest and lowest quartiles of intake of any cerebrovascular disease, ischaemic stroke and intracerebral haemorrhage were 0·75 (95 % CI 0·59, 0·94), 0·73 (95 % CI 0·54, 1·00) and 0·47 (95 % CI 0·24, 0·92), respectively. These associations were primarily due to the consumption of citrus fruits and occurred only in men. Total consumption of vegetables or cereals was not associated with the cerebrovascular disease incidence. The consumption of cruciferous vegetables, however, predicted a reduced risk of cerebrovascular diseases (RR 0·79; 95 % CI 0·63, 0·99), ischaemic stroke (RR 0·67; 95 % CI 0·49, 0·92) and intracerebral haemorrhage (RR 0·49; 95 % CI 0·25, 0·98). In conclusion, the consumption of fruits, especially citrus, and cruciferous vegetables may protect against cerebrovascular diseases.