[News release] Air pollution linked to increased risk of anxiety and stroke

Remember, correlation does not mean cause! See also the rebuttal below

From the 24 March 2015 MedicalExpress item

Air pollution is linked to a higher risk of stroke, particularly in developing countries, finds a study published in The BMJ today. In a second article, new research also shows that air pollution is associated with anxiety.

Stroke is a leading cause of death and kills around 5 million people each year worldwide. Common risk factors include obesity, smoking and high blood pressure. But the effect of the environment, such as, air pollution is uncertain because evidence is lacking.

In a systematic review and meta analysis, a team of researchers from Edinburgh University looked at the association between short term air pollution exposure and stroke related hospital admissions and deaths. In total, they analysed 103 observational studies that covered 28 countries across the world.

Gaseous pollutants included in the analysis were carbon monoxide, sulphur dioxide, nitrogen dioxide and ozone. In addition, particulate matter was included: PM 2.5 (fine particles less than 2.5 µm in size) and PM 10 (coarse particles less than 10 µm in size).

Results showed an association between carbon monoxide (1.5% increased risk per 1 ppm), sulphur dioxide (1.9% per 10 ppb) and nitrogen dioxide (1.4% per 10 ppb) and stroke related hospital admissions or death. The weakest association was found for ozone.

Both PM 2.5 and PM 10 were associated with hospital admissions or deaths due to stroke, by 1.1% and 0.3% per 10 µg/m3 increment respectively. The first day of air pollution exposure was found to have the strongest association.

Low- to middle-income countries experienced the strongest associations compared to high-income countries. Only 20% of analysed studies were from low- to middle-income countries – mostly mainland China – despite these countries having the highest burden of stroke.

…

Both studies were observational and no definitive conclusions can be drawn about cause and effect, and the teams of researchers call for more research.

..

Related articles
From the article below
““The study purporting to link air quality to anxiety is much less convincing. By far the most likely explanation, especially given that more recent exposure has a greater effect, is that the anxiety relates to traffic (noise, increased risk of accident) than to air pollutants themselves. Even though the authors say that living nearer to main roads was allowed for, this does not take away concern that having to walk/drive around in an area with greater traffic flows was not the major influence on this association. Other potential confounders such as green space were also not allowed for. There are also no real plausible mechanisms why this association shouldn’t be other than one which has arisen by chance. I am surprised that this was accepted for publication given these weaknesses and concerned that this will result in inappropriate anxiety in readers.””

• expert reaction to two papers on air pollution and stroke/anxiety

[Press release] U.S. stroke deaths declining due to improved prevention, treatment

From the 5 December 2013 American Heart Association press release

Statement Highlights:

• Better blood pressure control, stop-smoking programs and faster treatment are a few of the reasons for a dramatic decline in U.S. stroke deaths in recent decades.

DALLAS, Dec. 5, 2013 — Stroke deaths in the United States have declined dramatically in recent decades due to improved treatment and prevention, according to a scientific statement published in the American Heart Association journal Stroke.

The American Stroke Association commissioned this paper to discuss the reasons that stroke dropped from the third to fourth leading cause of death.

“The decline in stroke deaths is one of the greatest public health achievements of the 20th and 21st centuries,” said Daniel T. Lackland, Dr. P.H., chair of the statement writing committee and professor of epidemiology at the Medical University of South Carolina, in Charleston, S.C. “The decline is real, not a statistical fluke or the result of more people dying of lung disease, the third leading cause of death.”

Public health efforts including lowering blood pressure and hypertension control that started in the 1970s have contributed greatly to the change, Lackland said.

Four-year trend in survival probability by periods 1987–1991, 1992–1996, 1997–2001, and 2002– 2006 among men and women aged 18 to 54 y with a first ischemic stroke.

 

Smoking cessation programs, improved control of diabetes and abnormal cholesterol levels, and better, faster treatment have also prevented strokes. Improvement in acute stroke care and treatment is associated with lower death rates.

“We can’t attribute these positive changes to any one or two specific actions or factors as many different prevention and treatment strategies had a positive impact,” Lackland said. “Policymakers now have evidence that the money spent on stroke research and programs aimed at stroke prevention and treatment have been spent wisely and lives have been saved.

“For the public, the effort you put into lowering your blood pressure, stopping smoking, controlling your cholesterol and diabetes, exercising and eating less salt has paid off with a lower risk of stroke.”

Stroke deaths dropped in men and women of all racial/ethnic groups and ages, he said.

“Although all groups showed improvement, there are still great racial and geographic disparities with stroke risks as well many people having strokes at young ages,” Lackland said. “We need to keep doing what works and to better target these programs to groups at higher risk.”

Co-authors are Edward J. Roccella, Ph.D., M.P.JN., committee chair; Anne F. Deutsch, R.N., Ph.D.; Myriam Fornage, Ph.D.; Mary G. George, M.D., M.S.P.H.; George Howard, Dr. P.H.; Brett M. Kissela, M.D., M.S.; Steven J. Kittner, M.D., M.P.H.; Judith H. Lichtman, Ph.D., M.P.H.; Lynda D. Lisabeth, Ph.D, M.P.H.; Lee H. Schwamm, M.D.; Eric E. Smith, M.D., M.P.H.; and Amytis Towfighi, M.D., on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Quality of Care and Outcomes Research, and Council on Functional Genomics and Translational Biology.

For the latest heart and stroke news, follow us on Twitter: @HeartNews.

For updates and new science from Circulation, follow @CircAHA.

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at www.heart.org/corporatefunding.

For Media Inquiries: (214) 706-1173

Darcy Spitz: (212) 878-5940; Darcy.Spitz@heart.org

Julie Del Barto (broadcast): (214) 706-1330; Julie.DelBarto@heart.org

For Public Inquiries: (800) AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Related articles

• American Heart Association reports U.S. stroke deaths declining due to improved prevention, treatment (clarksvilleonline.com)
• U.S. Stroke Deaths Declining Due to Improved Prevention, Treatment (newsroom.heart.org)
• US stroke deaths declining due to improved prevention, treatment (eurekalert.org)
• Improved prevention, treatment leads to decline in U.S stroke deaths (medicalnewstoday.com)
• Decline in Stroke Death Among Americans: Study Confirms (scienceworldreport.com)
• Improved Prevention, Treatment Led to Significant Declines in US Stroke Death (counselheal.com)
• Blood pressure control tied to decline in stroke mortality over past 50 years (drsonnywong.wordpress.com)
• Blood pressure control tied to decline in stroke mortality over past 50 years (drkevincoy.wordpress.com)

 

Smoking Marijuana Associated With Higher Stroke Risk in Young Adults

Cannabis and pipe (Photo credit: Wikipedia)

 

From the 6 February 2013 article at Science Daily

 

Marijuana, the most widely used illicit drug, may double stroke risk in young adults, according to research presented at the American Stroke Association’s International Stroke Conference 2013.

In a New Zealand study, ischemic stroke and transient ischemic attack (TIA) patients were 2.3 times more likely to have cannabis, also known as marijuana, detected in urine tests as other age and sex matched patients, researchers said.

“This is the first case-controlled study to show a possible link to the increased risk of stroke from cannabis,” said P. Alan Barber, Ph.D., M.D., study lead investigator and professor of clinical neurology at the University of Auckland in New Zealand. “Cannabis has been thought by the public to be a relatively safe, although illegal substance. This study shows this might not be the case; it may lead to stroke.”

…

In previous case reports, ischemic stroke and TIAs developed hours after cannabis use, Barber said. “These patients usually had no other vascular risk factors apart from tobacco, alcohol and other drug usage.”

It’s challenging to perform prospective studies involving illegal substances such as cannabis because “questioning stroke and control patients about cannabis use is likely to obtain unreliable responses,” Barber said.

In the study, the regional ethics committee allowed researchers to use urine samples from other hospitalized patients. But researchers knew only the age, sex and ethnicity for matching due to a lack of consent.

The study provides the strongest evidence to date of an association between cannabis and stroke, Barber said. But the association is confounded because all but one of the stroke patients who were cannabis users also used tobacco regularly.

“We believe it is the cannabis and not tobacco,” said Barber, who hopes to conduct another study to determine whether there’s an association between cannabis and stroke independent of tobacco use. “This may prove difficult given the risks of bias and ethical strictures of studying the use of an illegal substance,” he said. “However, the high prevalence of cannabis use in this cohort of younger stroke patients makes this research imperative.”

Physicians should test young people who come in with stroke for cannabis use, Barber said.

“People need to think twice about using cannabis,” because it can affect brain development and result in emphysema, heart attack and now stroke, he said….

 

Read the entire article here

 

Related articles

• Smoking cannabis ‘doubles’ risk of stroke in young adults (metro.co.uk)
• Could Marijuana Cause Strokes? (ivanhoe.com)

 

The New Science Behind America’s Deadliest Diseases – WSJ.com

The New Science Behind America’s Deadliest Diseases – WSJ.com (16th July 2012)

What do heart disease, diabetes, Alzheimer’s, stroke and cancer have in common? Scientists have linked each of these to a condition known as chronic inflammation, and they are studying how high-fat foods and excess body weight may increase the risk for fatal disorders.

While much focus has been on fighting inflammation with drugs, researchers are getting a better understanding of the links connecting diet, inflammation and illness and discovering ways that foods can help keep inflammation in check. Laura Landro has details on Lunch Break.

Inflammation is the body’s natural response to injury and outside irritants. But when the irritants don’t let up, because of a diet of high-fat foods, too much body fat and smoking, for example, the immune system can spiral out of control and increase the risk for disease. Experts say when inflammation becomes chronic it can damage heart valves and brain cells, trigger strokes, and promote resistance to insulin, which leads to diabetes. It also is associated with the development of cancer.

Much of the research on chronic inflammation has focused on fighting it with drugs, such as cholesterol-lowering statins for heart disease. A growing body of research is revealing how abdominal fat and an unhealthy diet can lead to inflammation. Some scientists are investigating how certain components in foods might help. Dietary fiber from whole grains, for instance, may play a protective role against inflammation, a recent study found. And dairy foods may help ease inflammation in patients with a combination of risk factors…

…A substance known as C-reactive protein, measured with a simple blood test, is an indicator of inflammation in the body. A report published in Archives of Internal Medicine in 2007, which analyzed results of 33 separate studies, found that losing weight can lower C-reactive protein levels. For each one kilogram, or 2.2 pounds, of weight loss, whether by dieting, exercise or surgery, the mean reduction in C-reactive protein among participants was 0.13 milligram per liter…

..At a meeting in Quebec City last week on abdominal obesity and its health risks, experts in cardiology, endocrinology, nutrition and related specialties presented a wide range of new research linking obesity to inflammation-related diseases…

Related articles

• What do heart disease, diabetes, Alzheimer’s, stroke and cancer have in common? (warmsouthernbreeze.wordpress.com)
• A.M. Vitals: Inflammation and Disease (blogs.wsj.com)
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• The silent killer: Modern lifestyle promotes Leaky Gut and low-level chronic inflammation (theaveragejoenewsblogg.com)
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May is National Stroke Awareness Month

The US Centers for Disease Control and Prevention has useful stroke information at May is National Stroke Awareness Month
The Web page includes information about symptoms and healthy lifestyles.
Links are given to related podcasts and publications.

Excerpts

Stroke is the third leading cause of death in the United States. It is also a leading cause of serious long-term disability. While most strokes occur in people aged 65 years or older, strokes can occur at any age.

Knowing the symptoms of stroke and calling 9-1-1 immediately if someone appears to be having a stroke are crucial steps in getting prompt emergency medical care for a stroke.  New treatments are available that can reduce the damage caused by a stroke for some victims, but these treatments need to be given soon after the symptoms start.

Know Your Signs and Symptoms

The American Stroke Association notes these five major signs of stroke:

• Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, or loss of balance and coordination.
• Sudden, severe headache with no known cause.

If you think someone is having a stroke, you should call 9–1–1 or emergency medical services immediately.  Receiving immediate treatment is critical in lowering the risk of disability and even death.

Quick Facts

• Stroke is the third leading cause of death in the United States. In 2006, 137,119 people died from stroke in the United States.
• Stroke is a leading cause of serious long-term disability.
• About 795,000 strokes occur in the United States each year. About 610,000 of these are first or new strokes. About 185,000 occur in people who have already had a stroke before.
• Nearly three-quarters of all strokes occur in people aged 65 years or older. The risk of having a stroke doubles each decade after the age of 55.
• Strokes can—and do—occur at ANY age. Nearly 25% of strokes occur in people younger than age 65.
• Stroke death rates are higher for African Americans than for whites, even at younger ages.
• According to the American Heart Association, stroke will cost almost $73.7 billion in both direct and indirect costs in 2010.
• It has been noted for several decades that the southeastern United States has the highest stroke mortality rates in the country. It is not completely clear what factors might contribute to the higher incidence of and mortality from stroke in this region.
• People with a family history of stroke have a higher risk.

Additional Resources

• US National Stroke Association includes links to Warning Signs of Stroke (Use FAST to remember the warning signs), What is Stroke (basic information, myths, types of stroke, treatment),  Prevention information, and Ways to Stay Informed (newsletters, Facebook, Twitter, etc).
  It also includes a Stroke Awareness Center with useful information for those interested in educating and raising awareness (and the rest of us!)
• American Stroke Association (Beta Version by the American Heart Assocation/American Stroke Association) with links to news stories, warning signs, and (hospital) stroke centers, Online Stroke Magazine, and more.
• Stroke: MedlinePlus with links to overviews, news items, diagnosis/symptoms, treatments, related issues, specific conditions, organizations, videos, and much more.
• Know Stroke can help you learn the signs of stroke and the importance of getting to the hospital quickly. Fast medical action is key to successful recovery from stroke. Stroke strikes fast, and you should too.

Related Articles

• Young adults’ beliefs about their health clash with risky behaviors (eurekalert.org)
• How Do Strokes Affect Women? (everydayhealth.com)
• Stroke Risk and African-Americans (everydayhealth.com)
• Know Your High Blood Pressure and Stroke Risk (everydayhealth.com)
• Stroke Risk Factors: What You Should Know (everydayhealth.com)

Atlas of the Human Body from the American Medical Association & Additional Anatomy Links

Atlas of the Human Body from the American Medical Association

Includes simple and clearly labelled diagrams of the circulatory system, the brain, the torso, the female reproductive system, and others.  Summaries of systems and related information. Each diagram and rendering contains a brief discussion of the system in question, along with a selection of related information on the left-hand side of the page. The section titled “Effects of Stroke” is quite effective, and this site will be a useful resource for the general public, medical professionals, and others working in related fields.

Other Online Human Body Atlases***

GetBodySmart – An Online Textbook about Human Anatomy and Physiology

“Visually Learn About the Human Body Using Our Interactive Animations”
Meant to supplement McGraw Hill Higher Education physical textbooks. Includes interactive animations and additional resources as quizzes and fact sheets. IPad compatible versions

BioDigitalHuman

A virtual 3D body that brings to life “thousands of medically accurate anatomy objects and health conditions in an interactive web-based platform.” Hundreds of interactive features and customized views that look through all of the body systems .Annotated Screenshots area save and share these powerful tools for use in a range of settings. While the Basic version is completely free, there are other levels of functionality available for a fee

Gray’s Anatomy 

The classic illustrated text of human anatomy (20th edition, 1918) is now available online. It is fully searchable by keyword, table of contents, or subject index containing 13,000 entries. From Bartleby.com.
InnerBody: Your Guide to Human Anatomy Online ***

“The place for fun, interactive and educational views of the human body.” You can explore human anatomy through illustrations, animation, tutorials, and descriptions.

Human Anatomy On-line 

“Human Anatomy On-line, the place for fun, interactive and educational views of the human body. This program contains over one hundred illustrations of the human body with animations and thousands of descriptive links.”

Google Body Browser

“layered, interactive, high resolution experience allows users to zoom, pan, rotate, the human body, and to visualize its organs, systems, bones, and muscles.”[From Google launches Body Browser/joycevalenz]

Human Anatomy

http://www.upstate.edu/cdb/education/grossanat/

Designed for first year medical students, useful for others taking biology related courses. Material arranged in  six sections ranging from extremities to the head and neck. Each area contains a variety of detailed anatomical charts, glossaries, and images.  Each section includes many radiology resources for different perspective of the human body through x-rays, CT scans, and MRIs. Other helpful resources include fact sheets, quizzes, teaching materials, and other freely available course materials offered from other medical schools.  State University of New York-Upstate Medical University [KMG]

Animated Anatomies 

“Animated Anatomies explores the visually stunning and technically complex genre of printed texts and illustrations known as anatomical flap books. These publications invite the viewer to participate in virtual autopsies, through the process of unfolding their movable leaves, simulating the act of human dissection. This exhibit traces the flap book genre beginning with early examples from the sixteenth century, to the colorful “golden age” of complex flaps of the nineteenth century, and finally to the common children’s pop-up anatomy books of today.”

Anatomy Arcade

A collection of  games, videos, and other multimedia excursions. Created by Australian science teacher Ben Crossett. Games here include jigsaw puzzles, crosswords, word searches, and the catch all Just For Fun.

Anatomy Resources (American Association of Anatomists) includes these and many more

Human Anatomy Learning Site 

From the Dartmouth Medical School, the Human Anatomy Learning Web Site is a work in progress, focusing on the needs of first-time students of human anatomy. Its aim is to help students learn clinically relevant anatomy with maximum efficiency.

Anatomy and Physiology Learning Modules

From the University of Minnesota.A collection of study aids for entry-level anatomy and physiology students. Self Tests … Inquiry, Ideas, Thoughts, Learning, Curriculum.

Pocket Body iPhone app (Google Chrome Biodigital Human)

The BioDigital Human is a 3D platform for the understanding of anatomy, disease and treatments.Interactive tools for exploring, dissecting, and sharing custom views, combined with detailed medical descriptions.

 

*** There are only a limited number of free comprehensive online human body atlases online.
If these do not fit your needs, consider going to a nearby public, academic, or medical library.

Many academic and medical libraries are open to the public (all libraries receiving state funding are open to the public). Don’t forget to ask for a reference librarian if you would like professional assistance!

Many academic and medical libraries provide at least some reference assistance to the public. Call ahead and ask about library services to the public. You may be pleasantly surprised.

As always, feel free to contact me by leaving a comment ( it will not be posted). Or email me at jmflahiff, currently residing at her yahoo dot com account.

I would be happy to search for an image or information meeting your needs. Will reply within 48 hour.

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