Influence of age and health behaviors on stroke risk: lessons from longitudinal studies

Source: Journal of the American Geriatrics Society 2010 Oct; 58 (suppl 2): s325-328

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Date of publication: October 2010

Publication type: Journal Article

In a nutshell: This study investigates the behavioral factors that have been shown to improve overall health and reduce the risk of stroke. This includes the effective management of hypertension, cessation of cigarette smoking for those who smoke, and maintaining a healthy diet and active physical lifestyle.

Length of publication: 4 page article

Some important notes: Please contact your local NHS library for the full text of this article. Follow this link to find your local NHS library.

Preventing stroke: action or crisis

Source: Health Service Journal

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Date of publication: June 2010

Publication type: Article

In a nutshell: This article is the first in a series. It focuses on the issue of stroke prevention, and in particular the concern that too little is being done in stroke prevention for patients with atrial fibrillation. The report considers how local services may be improved to deal with this problem.

Length of publication: 4 pages

Prevention of cardiovascular disease at population level

Source: NICE

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Date of publication: June 2010

Publication type: Public Health Guidance

In a nutshell: This document provides guidance on the prevention of cardiovascular disease, including stroke, at population level. The guidance comprises two sets of recommendations aimed at national policy makers and local practitioners respectively.

Length of publication: 124 pages

Progress in improving stroke care

Source: National Audit Office

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Date of publication: February 2010

Publication type: Report

In a nutshell: This report by the Audit Office states that the Department of Health’s strategy for stroke care has increased awareness of the condition and started to improve care and outcomes. However, improvements have not been universal, health and social care services are not working together as they should, a third of patients do not receive a follow up appointment within six weeks, and half of all stroke survivors say that they are offered no advice on stroke prevention when leaving hospital.

Length of publication: 46 page report

Acknowledgement: HSJ

An increased risk of stroke among panic disorder patients: a 3-year follow-up study

Source: Canadian Journal of Psychiatry 2010 Jan; 55 (1): 43-49

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Date of publication: January 2010

Publication type: Journal Article

In a nutshell: This study considers if patients with panic disorder are at an increased risk of stroke. Using a population-based cohort design, the study finds that panic disorder is an independent risk factor for stroke and in patients with the condition, treatment can be considered as a part of stroke prevention.

Length of publication: 7 page article

Atrial fibrillation – detection and optimal therapy in primary care

Source: NHS Evidence Quality and Productivity

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Date of publication: November 2009

Publication type: Best practice

In a nutshell: Each year there are 16,000 strokes in patients who have atrial fibrillation. Warfarin reduces the risk of stroke by 50-70%, but an estimated 46% of patients who would benefit from anticoagulants are not receiving them. This case study outlines details of savings which have been made to NHS Trusts by identifying patients with atrial fibrillation and preventing stroke.

Length of publication: 7 pages

Some important notes: The case study is based on a project run by the NHS Stroke Improvement Programme.

Replacing aspirin and warfarin for secondary stroke prevention: is it worth the costs?

Source: Current Opinion in Neurology 2009 Nov 25. [Epub ahead of print]

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Date of publication: November 2009

Publication type: Journal Article

In a nutshell: This study aims to determine if it is cost-effective to replace aspirin and warfarin with more effective, yet more costly, treatments for secondary stroke prevention.

Commissioning for stroke prevention in primary care – the role of atrial fibrillation

Source: NHS Improvement

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Date of publication: July 2009

Publication type: Guidance

In a nutshell: This document looks at the evidence surrounding Atrial Fibrillation management in Primary Care and discusses how the development of strategies to identify, diagnose and treat patients can reduce the risk of stroke.

Length of publication: 16 page document

Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation

Source: NHS Improvement

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Date of publication: June 2009

Publication type: Website

In a nutshell: Atrial Fibrillation accounts for 14% of all strokes. The GRASP-AF tool applies a stratification tool to Atrial Fibrillation patients to determine their risk of stroke. The tool can be accessed by sending contact details to the Improvement Network.

Length of publication: 1 webpage, with links to guidance, a presentation and toolkit.                                                                                                                        

 

Why brushing your teeth regularly can prevent a stroke

Source: Daily Mail 12th May 2009

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Year of publication: 2009

Publication type: News Item

In a nutshell: Brushing your teeth and gums regularly could reverse early signs of heart disease. In fact, researchers suggest that good dental care can achieve results comparable to those from drugs by reducing dangerous fatty deposits on blood vessel walls. Scientists have long suspected that periodontitis, also known as gum or gingival disease, is linked to early signs of heart disease, specifically atherosclerosis – the buildup of fatty deposits in the arteries. But the new study has now identified a specific bacteria – porphyromonas gingivalis – as one of the main culprits in both gum and heart disease.

Length of publication: 1 page news item

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Link here for more information: Details of the original article on which these comments are based can be viewed at http://www.fasebj.org/cgi/content/abstract/23/4/1196

Routine aspirin benefits queried

Source: BBC 28th May 2009

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Year of publication: 2009

Publication type: News Item

In a nutshell: Low-dose aspirin should not routinely be used to prevent heart attacks and strokes, contrary to official guidance, say UK researchers. Analysis of data from over 100,000 clinical trial participants found the risk of harm largely cancelled out the benefits of taking the drug. Only those who have already had a heart attack or stroke should be advised to take a daily aspirin, they found. The Lancet study should help clarify a “confusing” issue, GPs said.

Length of publication: 1 page news item

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Link here for more information: Details of the original article on which these comments are based can be viewed at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60503-1/fulltext

Management of patients with stroke or TIA: assessment, investigation, immediate management and secondary prevention

Source: SIGN

For full text link here

Year of publication: 2008

Publication type: Guideline

In a nutshell: This guideline provides recommendations based on current evidence for best practice in the management of patients with stroke or TIA.  It provides recommendations on:

• early management of suspected stroke
• treatment of patients with ischaemic stroke, TIA or primary intracerebral haemorrhage (PICH)
• reducing the risk of recurrence of further stroke by medical and surgical interventions and lifestyle changes
• providing information and support tailored to the needs of patients and carers.

Length of publication: 100 page document

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