Aging, Author Interviews, Brigham & Women's - Harvard, Dermatology, Heart Disease, Herpes Viruses, Stroke / 23.11.2022

MedicalResearch.com Interview with:| Sharon G. Curhan, MD, ScM| Director, CHEARS: The Conservation of Hearing Study Channing Division of Network Medicine Department of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response:       Herpes zoster, commonly known as “shingles,” is a viral infection that often causes a painful rash. Shingles can occur anywhere on the head or body. Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person has chickenpox, the virus stays in their body for the rest of their life. Years and even decades later, the virus may reactivate as shingles. Almost all individuals age 50 years and older in the US have been infected with the varicella zoster virus and therefore they are at risk for shingles. About 1 in 3 people will develop shingles during their lifetime, and since age is a risk factor for shingles, this number may increase as the population ages. The risk is also higher among individuals of any age who are immunocompromised due to disease or treatment. A number of serious complications can occur when a person develops shingles, such as post-herpetic neuralgia (long-lasting pain), but there was limited information on whether there are other adverse long-term health implications of developing shingles. There is a growing body of evidence that links VZV, the virus that causes shingles, to vascular disease. VZV vasculopathy may cause damage to blood vessels and increase the risk of stroke or coronary heart disease. Although some previous studies showed a higher risk of stroke or heart attack around the time of the shingles infection, it was not known whether this higher risk persisted in the long term. Therefore, the question we aimed to address in this study was to investigate whether shingles is associated with higher long-term risk of stroke or coronary heart disease. To address this question, we conducted a prospective longitudinal study in 3 large US cohorts of >200,000 women and men, the Nurses’ Health Study (>79,000 women), the Nurses’ Health Study II (almost 94,000 women) and the Health Professionals Follow-Up Study (>31,000 men), without a prior history of stroke or coronary heart disease. We collected information on shingles, stroke and coronary heart disease on biennial questionnaires and confirmed the diagnoses with medical record review. We followed the participants for up to 16 years and evaluated whether those who had developed shingles were at higher risk for stroke or coronary heart disease years after the shingles episode. The outcomes we measured were incident stroke, incident coronary heart disease [defined as having a non-fatal or fatal myocardial infarction (heart attack) or a coronary revascularization procedure (CABG, coronary artery bypass graft or percutaneous transluminal coronary angioplasty)]. We also evaluated a combined outcome of cardiovascular disease, which included either stroke or coronary heart disease, whichever came first. (more…)
Author Interviews, Heart Disease, JAMA, Primary Care, Stroke, USPSTF / 06.09.2022

MedicalResearch.com Interview with: Katrina E. Donahue, M.D., M.P.H. Professor and Vice Chair of Research Chapel Hill Department of Family Medicine University of North Carolina Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease and stroke are the leading causes of death in the U.S. The Task Force found that people who are 40 to 75 years old and at high risk for heart disease should take a statin to help protect their health. People in this age group who are at increased risk but not high risk should make an individual decision with their healthcare professional about whether taking a statin is right for them. There is not enough research to determine whether statins are beneficial for people 76 years and older. (more…)
Author Interviews, Mental Health Research, Stroke / 06.12.2021

MedicalResearch.com Interview with: Professor Andrew Smyth MB, BCh, BAO, MMedSc, MRCPI, PhD Professor of Clinical Epidemiology NUI Galway Director of the HRB-Clinical Research Facility Galway Consultant Nephrologist at Galway University Hospitals MedicalResearch.com: What is the background for this study? Response: We know that there are multiple medium to long-term risk factors for stroke, as people with conditions such as hypertension (high blood pressure) or diabetes mellitus (high blood glucose levels) and those with risk factors (such as smoking, obesity, poor diet quality and others) are at increased risk of stroke. However, we still find it difficult to predict who will have a stroke. We were interested in exploring if short-term exposures to anger or emotional upset or a period of heavy physical exertion might lead to, or ‘trigger’ a stroke. We looked at this previously for myocardial infarction (heart attack) in a study called INTERHEART. Some smaller studies have looked at this before, with less people experiencing a stroke and often confined to one country or geographical region. Here, in INTERSTROKE, we included over 13,000 people who had a stroke and asked about the one hour period before the onset of the stroke and also about the same period on the day before.  (more…)
Author Interviews, NEJM, Stroke, University Texas / 08.09.2021

MedicalResearch.com Interview with: James Grotta, MD Director of Stroke Research Clinical Institute for Research and Innovation Memorial Hermann - Texas Medical Center Director, Mobile Stroke Unit Consortium University of Texas Health  MedicalResearch.com: What is the background for this study? Response: We have good stroke treatments (thrombolysis and thrombectomy).  Since the initial studies showing benefit of thrombolysis, it has been difficult to improve on the amount of benefit except by speeding its delivery; the earlier the treatment, the better the outcome. Biologically, treatment in the first hour is likely to have greatest benefit since the brain is less irreversibly damaged and the clot is more soluble. But treatment in the first hour is rare if it is carried out in the emergency department.  So MSUs take the emergency department to the patient. We know that Mobile Stroke Units (MSUs) can speed treatment; our study addressed if this be accomplished in the US, and how much difference does it make in outcome.  In particular, outcomes important to patients given the probable costs of implementing MSUs.  (more…)
Author Interviews, Heart Disease, NEJM, Salt-Sodium, Stroke / 03.09.2021

MedicalResearch.com Interview with: Maoyi TIAN PhD Program Head, Digital Health and Head, Injury & Trauma Senior Research Fellow The George Institute MedicalResearch.com: What is the background for this study? Response: There is clear evidence from the literature that sodium reduction or potassium supplementation can reduce blood pressure. Reduced blood pressure can also lead to a risk reduction for cardiovascular diseases. Salt substitute is a reduced sodium added potassium product combined those effects. Previous research of salt substitute focus on the blood pressure outcome. There is no evidence if salt substitute can reduce the risk of cardiovascular diseases or pre-mature death. This study provided a definitive evidence for this unaddressed question. MedicalResearch.com: What are the main findings? The main findings of the research were:
  • The salt substitute reduced the risk of stroke by 14%
  • The salt substitute reduced the risk of major adverse cardiovascular events by 13%
  • The salt substitute reduced the risk of pre-mature death by 12%
(more…)
Author Interviews, COVID -19 Coronavirus, Stroke / 06.04.2021

MedicalResearch.com Interview with: Dr. Thanh Nguyen MD Director of Interventional Neurology/ Neuroradiology Boston Medical Center MedicalResearch.com: What is the background for this study? Response: During the first wave of the COVID-19 pandemic in the spring of 2020, there were many regional and sometimes national reports of declines in stroke and myocardial infarction volumes. Our goal was to understand whether these declines were also seen for other neurological emergencies such as subarachnoid hemorrhage hospitalizations and ruptured aneurysm endovascular treatments. (more…)